Predictors of persistent central serous chorioretinopathy: a multicenter retrospective study - MICRoN report number four

Abstract

Purpose While central serous chorioretinopathy (CSCR) frequently resolves after the first episode, in 30-50% of cases, subretinal fluid (SRF) persists and can substantially impair vision. To identify persistence predictors, this study compared demographic, clinical, and imaging data between patients with resolution and SRF persistence. Methods Retrospective data were collected at baseline and follow-up from 308 eyes of 295 patients with CSCR in collaboration with the Macula Society CSCR Study Group. Patients were divided into a resolved (RG) and a persistent CSCR group (PG). Patients with known recurrence after resolution were excluded. Optical coherence tomography (OCT) biomarkers including central macular thickness (CMT), subfoveal choroidal thickness (SFCT), neurosensory detachment height (NSD), Haller layer thickness, inner choroidal thickness (ICT), and choroidal vascularity index (CVI) were analysed. Results PG had 148 eyes and RG had 160 eyes. Mean age in PG vs RG was 47.62 +/- 11.63 vs. 44.89 +/- 10.12 years (p = 0.029). Mean presenting symptom duration was significantly greater in PG than RG (8.67 +/- 23.33 vs. 4.33 +/- 31.18 months) (p = 0.005). There was a higher frequency of complex cases (21.6%) in PG (p < 0.001). Baseline mean CMT (358.11 +/- 157.02 microns) and NSD height (175.78 +/- 134.34 microns) were significantly lower in PG (p = 0.007). Multivariate logistic regression analysis showed that each additional year of age was associated with a 22.3% increase in the odds of having persistent SRF. Conclusion Age at presentation, symptom duration, baseline CMT and NSD height may serve as practical risk stratifiers to identify eyes at high risk for chronicity in CSCR.