Is tobacco consumption a risk factor for central serous chorioretinopathy? A systematic review and meta-analysis

Central serous chorioretinopathy (CSC) is a prevalent exudative maculopathy. Understanding risk factors for CSC is important for disease prevention and to provide evidence-based advice to patients. In this study, we systematically reviewed the literature and performed meta-analysis on the association between tobacco consumption and CSC. We searched 12 literature databases on May 5, 2024, and identified 11 eligible studies of 27 595 patients with CSC and 105 354 control individuals. Studies were predominantly clinic-based case-control studies. We calculated a summary estimate of tobacco consumption as a risk factor for CSC at an odds ratio of 2.99 (95% CI: 1.82-4.93, p = 0.000017), which remained statistically significant in the sensitivity analyses. The exact mechanism by which tobacco consumption contribute to the pathophysiology of CSC remains unclear, although several potential hypotheses exist. However, tobacco consumption is a modifiable behaviour and tobacco cessation is an actionable advice with which patients with CSC themselves can play a large role in disease management. Further studies are warranted to understand the impact of tobacco cessation for risk modification and for the prognosis of patients who already have CSC.