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ORIGINAL ARTICLE
Year : 2022  |  Volume : 12  |  Issue : 4  |  Page : 415-422

The associations between central serous chorioretinopathy and muscle relaxants: A case–control study


1 Department of Ophthalmology, Veer Chandra Singh Garhwali, Government Institute of Medical Sciences and Research, Srinagar, Uttarakhand, India; Department of Ophthalmology, NMC Hospital, Al Ain, United Arab Emirates
2 Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
3 Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
4 Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada
5 Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada; Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
6 Department of Ophthalmology, NMC Hospital, Al Ain, United Arab Emirates

Correspondence Address:
Dr. Manish Jain
Department of Ophthalmology, Veer Chandra Singh Garhwali, Government Institute of Medical Sciences and Research, Srinagar - 246 174, Uttarakhand

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2211-5056.361975

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PURPOSE: To evaluate the role of muscle-relaxants as risk factors for the development of central serous chorioretinopathy (CSC) - the second most common retinopathy in our settings; despite multiple risk factors seen in our patients, 21% were initially labelled as idiopathic. MATERIALS AND METHODS: Retrospective case-control study at a tertiary hospital in the United Arab Emirates, where we reviewed the medical records of 273 patients with CSC examined between 2010 and 2019 for use of muscle-relaxants including tolperisone/eperisone, carisoprodol and gabapentin/pregabalin within a year of onset/recurrence of the disease. Intake of drugs with known association with CSC (including corticosteroids/sympathomimetics) was also recorded. Two hundred eighty-six subjects with adverse events seen at the same institute during the same study period served as controls. Odds ratios, Chi-Square tests and multivariate logistic regression were carried out to determine any associations with the muscle-relaxants and other pharmacological confounders - corticosteroids/sympathomimetics. RESULTS: Muscle relaxants may increase the risk of CSC as evident on multivariate regression analysis (OR: 2.55; confidence interval [CI]: 1.208-5.413); the significance was retained on removing the 6 subjects who had corticosteroids/sympathomimetics (OR: 2.30; CI: 1.073–4.939). Univariate analysis yielded an OR of 2.52 for muscle relaxants (CI: 1.2149–5.2276), 2.96 for eperisone/tolperisone (CI: 1.3531–6.5038), and 6.26 for eperisone as an individual agent (CI: 1.8146–21.6252). CONCLUSION: We found muscle relaxants to be associated factors of CSC regardless of inclusion of corticosteroids/sympathomimetics (P < 0.05). Among individual classes of muscle relaxants in this study, only eperisone/tolperisone posed a significant risk (P < 0.05). The vascular smooth muscle relaxation could be the possible mechanism that affects the choroidal blood flow and indirectly predisposes to CSC.


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