During Eight-year Follow-Up, More than Half of CSCR Cases Experience Recurrence

In this study, a longer total SRF duration was associated with worse final visual acuity. SRF accumulation increases the separation between the outer retina and choroid, thereby disrupting the adequate supply of nutrients. This disruption is thought to underlie the photoreceptor layer damage observed in CSCR. Photo: Mohammad Rafieetary, OD. Click image to enlarge. While observation without active treatment is generally considered an appropriate management strategy in acute cases of central serous chorioretinopathy (CSCR), its disease course can vary considerably among patients, with some developing recurrent episodes or progressing to its chronic form. Understanding the long-term course of CSCR is essential for effective patient counseling and the development of appropriate management strategies. In a recent study, researchers based in South Korea evaluated long-term clinical outcomes of patients with CSCR over a mean follow-up of 8.2 years.The study found that younger age was associated with a higher risk of recurrence; on average, patients with recurrence were 3.4 years younger than those without recurrence. Longer total subretinal fluid (SRF) duration, development of choroidal neovascularization CNV and worse baseline best-corrected visual acuity (BCVA) were all significantly associated with poorer final BCVA.This retrospective study, which was published in BMC Ophthalmology, included 140 eyes diagnosed with idiopathic CSCR and followed up for ≥ five years (mean, 98.9 months). The overall mean patient age was 49.2 years. During the first year after diagnosis, patients were followed up at one- to three-month intervals. Thereafter, the follow-up interval was extended to four to six months at the discretion of the physician. OCT was performed at every follow-up visit.Resolution of the first episode occurred in all eyes, with 62.1% of cases resolving within six months. CSCR recurred in 55.7% of cases at a mean of 25.7 months after resolution. The mean number of episodes was 2.1. Mean logMAR (logarithm of minimum angle of resolution) BCVA was 0.18 at baseline, 0.13 at one year, 0.18 at three years and 0.25 at the final visit. Compared to baseline values, BCVA significantly worsened at the final visit. Visual deterioration of ≥ 0.3 logMAR occurred in 14.3% patients. Younger age was associated with a higher risk of recurrence; on average, patients with recurrence were 3.4 years younger than those without recurrence.In the present study, treatment was administered in more than half of the patients, most of whom received anti-VEGF therapy.No standardized treatment protocol for CSCR was applied, and treatment decisions, including anti-VEGF injection, laser photocoagulation, photodynamic therapy or combination therapy, were made at the physician’s discretion. In cases where CNV developed, anti-VEGF therapy was administered. In this study, only cases accompanied by exudation or hemorrhage were classified as CNV development, whereas suspected cases of silent or inactive CNV were not categorized separately.“Although the multivariate analysis did not demonstrate a significant association between treatment status and final visual outcome, our findings may have been influenced by the type of treatment modality used,” the study authors emphasized. “Consequently, it is difficult to accurately assess the impact of laser photocoagulation or photodynamic therapy on the prognosis of CSCR based on our data.”Accurate differentiation requires confirmation of neovascularization or the presence of polypoidal lesions, which cannot always be clearly identified using OCT and fluorescein angiography alone. Therefore, the possibility that some patients diagnosed with CSCR in this study may actually have had pachychoroid neovasculopathy or polypoidal choroidal vasculopathy cannot be completely excluded. Thus, this diagnostic limitation, related to the reliance on OCT and fluorescein angiography alone, may have had some influence on the visual outcomes reported in this study.“Active interventions to promote SRF resolution may help preserve long-term visual outcomes in patients with persistent SRF that does not resolve in a timely manner,” the researchers concluded.Click here for the journal source. Na DG, Kim CG, Kim JH. Long-term clinical outcomes and prognostic factors of central serous chorioretinopathy. BMC Ophthalmol. April 11, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.