Californian researchers have found that patients with varicose veins were almost twice as likely as matched peers without the condition to be diagnosed with central serous chorioretinopathy – where fluid builds up under the retina, reports Medscape.
They said this association persisted after excluding glucocorticoid users and matching for known risk factors, lending support to the idea that systemic venous dysfunction may contribute to this eye disease.
The team, led by Bertan Cakir of the Byers Eye Institute, Stanford University School of Medicine in Palo Alto, had analysed de-identified electronic health records from a large global network to assess whether varicose veins are linked to a later diagnosis of central serous chorioretinopathy.
They included 621 513 patients with varicose veins (mean age, 55.8 years; 60.1% women) and an equal number of matched control individuals (matched on age, sex, race, and ethnicity); all had a general adult medical examination and no prior diagnosis of central serous chorioretinopathy or serous pigment epithelial detachment.
To account for steroid exposure, they conducted a secondary analysis by excluding patients with any history of glucocorticoid use; 122 197 patients with varicose veins (mean age, 52.1; 53.6% women) were included and compared with an equal number of matched control individuals. These groups were additionally matched for healthcare use, hypertension, and sleep apnoea.
Further analysis compared the rates of deep vein thrombosis and pulmonary embolism among those with varicose veins with and without central serous chorioretinopathy.
The main outcome was a new diagnosis of central serous chorioretinopathy or serous pigment epithelial detachment after the medical examination.
Findings
Patients with varicose veins were about twice as likely as the matched control individuals to receive a subsequent diagnosis of central serous chorioretinopathy (risk ratio [RR], 2.16; P < .0001). Serous pigment epithelial detachment was also diagnosed more often in patients with varicose veins (RR, 1.97; P < .0001).
The association persisted for central serous chorioretinopathy (RR, 1.83; P = .003) and serous pigment epithelial detachment (RR, 1.95; P = .013) in the secondary analysis.
In an analysis restricted to patients aged 18-60 intended to avoid misclassification with age-related macular degeneration, the association remained significant for both central serous chorioretinopathy and serous pigment epithelial detachment.
Among patients with varicose veins, those with and without central serous chorioretinopathy showed no significant differences in the rates of deep vein thrombosis (P = .078) or pulmonary embolism (P = .14).
“These findings are consistent with prior genetic studies implicating shared endothelial pathways,” the researchers reported.
Study details
Association between varicose veins and central serous chorioretinopathy
Bertan Cakir, Negin Yavari, Lucie Guo et al.
Published in the British Journal of Ophthalmology on 7 October 2026
Aim
To 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.
BMJ article – Association between varicose veins and central serous chorioretinopathy (Open access)
Medscape article – Varicose Veins Tied to Risk for Fluid Buildup Under Retina (Open access)
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