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

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:...

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Bibliographic Details
Main Authors: Manish Jain, Sunir J Garg, Mohammad Khan, Varun Chaudhary, Dena Zeraatkar, Dhanya Kurian, Sarath Lal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Taiwan Journal of Ophthalmology
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Online Access:http://www.e-tjo.org/article.asp?issn=2211-5056;year=2022;volume=12;issue=4;spage=415;epage=422;aulast=Jain
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Summary: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.
ISSN:2211-5056
2211-5072