Association between central serous chorioretinopathy and personality types: A systematic review and meta-analysis

In this study, we systematically review and synthesize the evidence on the association between central serous chorioretinopathy (CSC) and personality types, and quantify the relationship between Type A behaviour and CSC. We systematically searched 12 literature databases on 5 October 2025 for studies in which personality types were evaluated in patients with CSC. Data extraction and risk-of-bias assessment followed standardized protocols. Studies were reviewed qualitatively. Random-effects meta-analysis was performed for the association between Type A behaviour and CSC. Twelve studies of 2176 participants (949 patients with CSC, 1227 controls) were included. Across studies, patients with CSC exhibited personality profiles marked by time urgency, competitiveness, emotional tension and maladaptive affect regulation, including higher neuroticism-anxiety, aggression-hostility and alexithymia scores. A significant association was found between Type A behaviour and CSC (pooled OR 3.43; 95% CI 1.94-6.07; p = 0.00002) in the four studies that evaluated this relationship. Sensitivity analysis confirmed robustness of the association. In conclusion, certain personality traits, particularly Type A behaviour, are associated with CSC. The relationship between personality and CSC appears biologically plausible given the role of stress-related hypothalamic-pituitary-adrenal axis activation and elevated cortisol levels, both recognized in CSC pathophysiology. However, complex biopsychosocial interactions without a direct causal pathway may also be the case. Understanding psychological predispositions may contribute to a more comprehensive view of CSC risk and care. Further longitudinal and mechanistic studies are warranted.