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Elevated Anxiety Levels in Central Serous Chorioretinopathy: Evidence from a Prospective Case-Control Study
Saloni Joshi1, Manavi D Sindal2, Maithili Umate3
1Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Introduction:
The aim of the study was to compare association of anxiety disorder in patients with CSCR and age-gender-matched healthy controls in a prospective study.
Methods:
This prospective cross-sectional case-control questionnaire-based survey included participants in the age group of 18-55 years, presenting with treatment naïve CSCR, as group A. Age and gender matched normal controls were included as group B. For assessment of anxiety, the Hamilton Anxiety Rating Scale (HAM-A) was administered to both groups by a trained study coordinator. The anxiety scores were graded as follows: no/minimal anxiety <7, mild 8-14, moderate 15-23, severe >24. The scoring was assessed using chi-square/Fischer's exact test.
Results:
The study recruited a total of 100 participants in each arm. There was a male preponderance in both groups, with a mean age of 39.61 + 6.07 years in group A and 40.07 + 8.74 years in group B. Among those with CSCR, 16% had mild anxiety, 46% moderate, 36% had severe, and 2% did not have any anxiety, while in the control population, 13% had moderate anxiety, and 1 had severe anxiety. The odds of those with CSCR having anxiety were 5 times more than the controls (OR 5.71 [4.20-7.22], p < 0.0001).
Conclusion:
This study highlights the strong association of anxiety with CSCR compared to healthy controls. Anxiety alters the internal hormonal milieu, leading to excess endogenous steroid secretion that contributes to the occurrence of CSCR. Addressing anxiety and encouraging lifestyle modifications in patients with CSCR can be a potential avenue to manage these cases.
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