Prevalence of Helicobacter pylori Infection in Patients with Central Serous Chorioretinopathy: A Review

Masood BAGHERI, Zahra RASHE, Mohammad Hosein AHOOR, Mohammad Hosein SOMI


Helicobacter pylori is a prevalent cause of gastrointestinal infections. Recently, several studies have shown a relationship between H. pylori infection and a variety of extradigestive manifestations. The aim of this study was to review the literature regarding the prevalence of this infection in cases of central serous chorioretinopathy (CSR). We reviewed the EMBASE, Cochrane Library, and Google Scholar search engines; hand-searched many journals; and searched the cited references in published articles for relevant studies. We assessed 81 studies for eligibility. Finally, nine articles that met the inclusion criteria were included. The relationship between H. pylori infection (as the etiologic factor) and chorioretinal involvement was assessed by the effect size with 95% confidence interval (CI). Both fixed- and random-effects models showed that the prevalence of H. pylori infection in patients with CSR was significantly higher than in the control group (2.5-fold and 2.7-fold higher, respectively; P < 0.01). The results were not significantly different between the two models. Treatment of H. pylori infection should be considered in patients with CSR. However, additional randomized controlled clinical trials are required to determine the possible role of H. pylori eradication in the prognosis and treatment of patients with CSR.


Hosseini H, Ghaffariyeh A, Nikandish R. Noxious compounds in exhaled air, a potential cause for ocular manifestations of H. pylori gastrointestinal infection. Med Hypotheses. 2007;68(1):91-3. doi: 10.1016/j.mehy.2006.06.029 pmid: 16919889

Mauget-Faysse M, Kodjikian L, Quaranta M, Ben Ezra D, Trepsat C, Mion F, et al. [Helicobacter pylori in central serous chorioretinopathy and diffuse retinal epitheliopathy. Results of the first prospective pilot study]. J Fr Ophtalmol. 2002;25(10):1021-5. pmid: 12527825

Sherman PM, Lin FY. Extradigestive manifestation of Helicobacter pylori infection in children and adolescents. Can J Gastroenterol. 2005;19(7):421-4. doi: 10.1155/2005/971974 pmid: 16010304

Zbinden R. Expanding the spectrum of Helicobacter pylori-associated diseases. Infection. 2005;33(2):49. doi: 10.1007/s15010-005-7205-3 pmid: 15827869

Sacca SC, Vagge A, Pulliero A, Izzotti A. Helicobacter pylori infection and eye diseases: a systematic review. Medicine (Baltimore). 2014;93(28):e216. doi: 10.1097/MD.0000000000000216 pmid: 25526440

Vardhan N, Chaudhary KP, Sharma V, Sharma SK, Sharma B. Helicobacter Pylori Positive Dyspepsia in Relation to Ocular Manifestations and Primary Open Angle Glaucoma. Offic Sci J Delhi Ophthalmol Soc. 2014;24(4):237-40.

Ojima Y, Tsujikawa A, Hangai M, Nakanishi H, Inoue R, Sakamoto A, et al. Retinal sensitivity measured with the micro perimeter 1 after resolution of central serous chorioretinopathy. Am J Ophthalmol. 2008;146(1):77-84. doi: 10.1016/j.ajo.2008.02.016 pmid: 18405876

Liew G, Quin G, Gillies M, Fraser-Bell S. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Exp Ophthalmol. 2013;41(2):201-14. doi: 10.1111/j.1442-9071.2012.02848.x pmid: 22788735

Albert DM, Jakobiec FA. Principles and practice of ophthalmology. Philadelphia, USA: Saunders; 1994.

Shah SP, Desai CK, Desai MK, Dikshit RK. Steroid-induced central serous retinopathy. Indian J Pharmacol. 2011;43(5):607-8. doi: 10.4103/0253-7613.84985 pmid: 22022013

van Dijk EH, Dijkman G, Biermasz NR, van Haalen FM, Pereira AM, Boon CJ. Chronic central serous chorioretinopathy as a presenting symptom of Cushing syndrome. Eur J Ophthalmol. 2016;26(5):442-8. doi: 10.5301/ejo.5000790 pmid: 27135093

Giusti C. Association of Helicobacter pylori with central serous chorioretinopathy: hypotheses regarding pathogenesis. Med Hypotheses. 2004;63(3):524-7. doi: 10.1016/j.mehy.2004.02.020 pmid: 15288381

Misiuk-Hojlo M, Michalowska M, Turno-Krecicka A. Helicobacter pylori--a risk factor for the developement of the central serous chorioretinopathy. Klin Oczna. 2009;111(1-3):30-2. pmid: 19517842

Asensio-Sanchez VM, Rodriguez-Delgado B, Garcia-Herrero E, Cabo-Vaquera V, Garcia-Loygorri C. [Central serous chorioretinopathy as an extradigestive manifestation of Helicobacter pylori gastric infection]. Arch Soc Esp Oftalmol. 2008;83(3):177-82. pmid: 18311677

Cotticelli L, Borrelli M, D'Alessio AC, Menzione M, Villani A, Piccolo G, et al. Central serous chorioretinopathy and Helicobacter pylori. Eur J Ophthalmol. 2006;16(2):274-8. pmid: 16703546

Ahnoux-Zabsonre A, Quaranta M, Mauget-Faysse M. [Prevalence of Helicobacter pylori in central serous chorioretinopathy and diffuse retinal epitheliopathy: a complementary study]. J Fr Ophtalmol. 2004;27(10):1129-33. doi: MDOI-JFO-12-2004-27-10-0181-5512-101019-ART06 [pii] pmid: 15687922

Nenciu A, Stefan C, Melinte D, Postaliu D. [Central serous chorioretinopathy--clinical aspects and course]. Oftalmologia. 2006;50(3):123-7. pmid: 17144519

Kmera-Muszynska M, Wojcicka I, Muszynski J. [Is Helicohacter pylori infection associated with CRS occurrence?]. Klin Oczna. 2008;110(7-9):273-6. pmid: 19112860

Misiuk-Hojlo M, Michalowska M, Zolynska M. [The role of Helicobacter pylori in etiopathogenesis of central serous choroidopathy]. Klin Oczna. 2007;109(10-12):479-81. pmid: 18488401

Mansuetta CC, Mason JO, 3rd, Swanner J, Feist RM, White MF, Jr., Thomley ML, et al. An association between central serous chorioretinopathy and gastroesophageal reflux disease. Am J Ophthalmol. 2004;137(6):1096-100. doi: 10.1016/j.ajo.2004.01.054 pmid: 15183795

Roshani M, Davoodi NA, Seyyedmajidi MR, Zojaji H, Sherafat SJ, Hashemi M, et al. Association of Helicobacter pylori with central serous chorioretinopathy in Iranian patients. Gastroenterol Hepatol Bed Bench. 2014;7(1):63-7. pmid: 25436099

Feghhi M, Hajiani E, Khataminia G. Incidence of Helicobacter pylori in central serous chorioretinopathy a case control study. Jundishapur J Microb. 2008;1(1):15-9.

Warrow D, Mukkamala K, Rosen RB. Relationship between Helicobacter Pylori and Central Serous Chorioretinopathy. Invest Ophthalmol Vis Sci. 2012;53(14):5227-7.

Egger M, Smith GD. Principles of and Procedures for Systematic Reviews. 2nd ed. London, UK: BMJ Books; 2001. 23-42 p.

Franceschi F, Sepulveda AR, Gasbarrini A, Pola P, Silveri NG, Gasbarrini G, et al. Cross-reactivity of anti-CagA antibodies with vascular wall antigens: possible pathogenic link between Helicobacter pylori infection and atherosclerosis. Circulation. 2002;106(4):430-4. pmid: 12135941

Jahani Sherafat S, Tajeddin E, Reza Seyyed Majidi M, Vaziri F, Alebouyeh M, Mohammad Alizadeh AH, et al. Lack of association between Helicobacter pylori infection and biliary tract diseases. Pol J Microbiol. 2012;61(4):319-22. pmid: 23484417

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