Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance

Purpose. Patients with central serous chorioretinopathy (CSC) typically present with acute visual impairment and metamorphopsia. The disease previously has been associated with psychological stress. Population-based cohort studies on the risk of CSC among patients with nonorganic sleep disturbance (...

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Main Authors: Peng-Tai Tien, Chien-Yu Lai, Chun-Ju Lin, Wen-Lu Chen, Po-Kang Lin, Chih-Hsin Muo, Yi-Yu Tsai, Lei Wan, Wen-Chao Ho, Hui-Ju Lin
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2020/1712503
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author Peng-Tai Tien
Chien-Yu Lai
Chun-Ju Lin
Wen-Lu Chen
Po-Kang Lin
Chih-Hsin Muo
Yi-Yu Tsai
Lei Wan
Wen-Chao Ho
Hui-Ju Lin
author_facet Peng-Tai Tien
Chien-Yu Lai
Chun-Ju Lin
Wen-Lu Chen
Po-Kang Lin
Chih-Hsin Muo
Yi-Yu Tsai
Lei Wan
Wen-Chao Ho
Hui-Ju Lin
author_sort Peng-Tai Tien
collection DOAJ
description Purpose. Patients with central serous chorioretinopathy (CSC) typically present with acute visual impairment and metamorphopsia. The disease previously has been associated with psychological stress. Population-based cohort studies on the risk of CSC among patients with nonorganic sleep disturbance (NOSD) are limited. An early sign of psychiatric disorder was probably sleep disturbance. Furthermore, psychological stress may be caused by sleep disturbance. We investigated the relationship between NOSD and the incidence of CSC. Design. Longitudinal cohort study. Participants. We used the Longitudinal Health Insurance Database and collected the data of 53,743 NOSD patients without CSC between 2000 and 2005 as the study group. Four-fold controls were selected randomly from those without neither sleep disturbance nor a CSC history with frequency matching of age, sex, and index-year. Methods. The difference in sex, age group, comorbidities, and steroid use between the two groups was analyzed by the χ2 test. Cox-proportional hazard regression was utilized to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for comparison of the two groups. Kaplan–Meier analysis was applied to measure the cumulative incidence of CSC. Furthermore, the log-rank test was used to test the incidence difference between the two groups. Main Outcome Measures. The incidence rate of CSC in the following years until 2011 was detected. Results. During a mean follow-up of 7.36 ± 2.88 years, NOSD patients had a higher incidence of CSC than the controls (3.10 vs. 1.86 per 10,000 person-years; adjusted HR, 1.65; 95% CI, 1.34–2.02). Men had a higher risk of CSC than women. Sensitivity analyses stratified by sex, age group, or comorbidity condition showed consistently that NOSD patients had a higher risk of CSC than their controls. Dose-response showed that higher NOSD severity had even higher CSC risk. Conclusions. NOSD is an independent indicator for the increased risk of subsequent CSC development.
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spelling doaj-art-116c971103e64f8fb6ef30399adf3da72025-08-20T02:01:56ZengWileyJournal of Ophthalmology2090-004X2090-00582020-01-01202010.1155/2020/17125031712503Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep DisturbancePeng-Tai Tien0Chien-Yu Lai1Chun-Ju Lin2Wen-Lu Chen3Po-Kang Lin4Chih-Hsin Muo5Yi-Yu Tsai6Lei Wan7Wen-Chao Ho8Hui-Ju Lin9Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, TaiwanSchool of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, TaiwanDepartment of Ophthalmology, China Medical University Hospital, Taichung, TaiwanGraduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanManagement Office for Health Data, China Medical University Hospital, Taichung, TaiwanGraduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, TaiwanGraduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Public Health, College of Public Health, China Medical University, Taichung, TaiwanDepartment of Ophthalmology, China Medical University Hospital, Taichung, TaiwanPurpose. Patients with central serous chorioretinopathy (CSC) typically present with acute visual impairment and metamorphopsia. The disease previously has been associated with psychological stress. Population-based cohort studies on the risk of CSC among patients with nonorganic sleep disturbance (NOSD) are limited. An early sign of psychiatric disorder was probably sleep disturbance. Furthermore, psychological stress may be caused by sleep disturbance. We investigated the relationship between NOSD and the incidence of CSC. Design. Longitudinal cohort study. Participants. We used the Longitudinal Health Insurance Database and collected the data of 53,743 NOSD patients without CSC between 2000 and 2005 as the study group. Four-fold controls were selected randomly from those without neither sleep disturbance nor a CSC history with frequency matching of age, sex, and index-year. Methods. The difference in sex, age group, comorbidities, and steroid use between the two groups was analyzed by the χ2 test. Cox-proportional hazard regression was utilized to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for comparison of the two groups. Kaplan–Meier analysis was applied to measure the cumulative incidence of CSC. Furthermore, the log-rank test was used to test the incidence difference between the two groups. Main Outcome Measures. The incidence rate of CSC in the following years until 2011 was detected. Results. During a mean follow-up of 7.36 ± 2.88 years, NOSD patients had a higher incidence of CSC than the controls (3.10 vs. 1.86 per 10,000 person-years; adjusted HR, 1.65; 95% CI, 1.34–2.02). Men had a higher risk of CSC than women. Sensitivity analyses stratified by sex, age group, or comorbidity condition showed consistently that NOSD patients had a higher risk of CSC than their controls. Dose-response showed that higher NOSD severity had even higher CSC risk. Conclusions. NOSD is an independent indicator for the increased risk of subsequent CSC development.http://dx.doi.org/10.1155/2020/1712503
spellingShingle Peng-Tai Tien
Chien-Yu Lai
Chun-Ju Lin
Wen-Lu Chen
Po-Kang Lin
Chih-Hsin Muo
Yi-Yu Tsai
Lei Wan
Wen-Chao Ho
Hui-Ju Lin
Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance
Journal of Ophthalmology
title Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance
title_full Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance
title_fullStr Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance
title_full_unstemmed Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance
title_short Increased Risk of Central Serous Chorioretinopathy among Patients with Nonorganic Sleep Disturbance
title_sort increased risk of central serous chorioretinopathy among patients with nonorganic sleep disturbance
url http://dx.doi.org/10.1155/2020/1712503
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