Association between varicose veins and central serous chorioretinopathy

AimTo investigate the association between varicose veins and central serous chorioretinopathy (CSCR), based on emerging genetic evidence of a shared vascular mechanism. METHODS: Propensity score-matched retrospective cohort study using the TriNetX Global Collaborative Network. Patients with varicose veins (n=621 513) were matched 1:1 to controls without varicose veins on age, sex, race and ethnicity, with prior CSCR or serous pigment epithelial detachment (PED) excluded. A secondary analysis excluded glucocorticoid users and additionally matched on hypertension, sleep apnoea and healthcare utilisation. A tertiary analysis compared thromboembolic risk (pulmonary embolism (PE) and deep vein thrombosis (DVT)) in varicose vein patients with and without CSCR. RESULTS: Varicose veins were significantly associated with CSCR (risk ratio (RR) 2.16; 95% CI 1.86 to 2.52; p<0.0001) and serous PED (RR 1.97; 95% CI 1.69 to 2.93; p<0.0001). Associations persisted after excluding glucocorticoid users and adjusting for comorbidities (CSCR RR 1.83; 95% CI 1.22 to 2.75; p=0.003; PED RR 1.95; 95% CI 1.38 to 3.34; p=0.013). Among varicose vein patients, rates of DVT (RR 1.36; p=0.078) and PE (RR 1.41; p=0.14) did not differ significantly between those with and without CSCR. CONCLUSIONS: Varicose veins were significantly associated with CSCR and serous PED, independent of glucocorticoid exposure and known comorbidities, supporting a possible systemic vascular mechanism in CSCR pathophysiology.