Helicobacter pylori in central serous chorioretinopathy and diffuse retinal epitheliopathy. Results of the first prospective pilot study

PURPOSE: Helicobacter pylori has been implicated in focal occlusive arterial diseases in young people. Central serous chorioretinopathy (CSC) and diffuse retinal epitheliopathy (DRE) being suspected vascular occlusive diseases of choriocapillaris, the purpose of this study was to determine the prevalence of H. pylori infection in patients with long-lasting (>6 months) CSC and/or DRE. METHODS: Sixteen consecutive patients living in southeastern France were included in this prospective pilot study. H. pylori infection was assessed by the (13)C-urea breath test, serology, as well as histology of gastric biopsy specimens in some cases. RESULTS: Evidence for H. pylori infection was detected in nine out of the 16 patients with active long-lasting CSC/DRE (56.3%). H. pylori-infected patients more frequently presented gastric pain (four of nine H. pylori-positive patients: 44%) than H. pylori-negative patients (one out of seven: 14%). Men were more frequently H. pylori-positive (seven men out of ten: 70%) than women (two women out of a total of six: 33%). DISCUSSION: When the prevalence of H. pylori infection (56.3%) was compared to the prevalence in a historical control population from southeastern France (27.5%), it was found to be significantly higher (P<0.05). CONCLUSION: These results may indicate a possible association between H. pylori infection and CSC/DRE manifestations. This new etiopathogenic hypothesis deserves to be confirmed in a national or international multicenter study because it could lead to a new therapeutic approach in CSC/DRE, i.e., Helicobacter pylori eradication.