Chronic central serous chorioretinopathy with and without myopia: clinical features and response to half-dose...

To compare the clinical characteristics, multimodal imaging features, and treatment response to half-dose photodynamic therapy (PDT) between patients with chronic central serous chorioretinopathy (cCSC) with and without myopia.

Sixty-six eyes with cCSC received a single session of half-dose PDT and were followed for at least 6 months. Patients were divided into myopic and non-myopic groups based on spherical equivalent less than -0.5 diopters. Multimodal imaging data, including optical coherence tomography (OCT), OCT angiography, fundus autofluorescence (FAF), and indocyanine green angiography (ICGA), were analyzed.

The study included 38 eyes in the myopic group and 28 in the non-myopic group. Among myopic eyes, 65.8% had low myopia, 28.9% moderate, and 5.3% high myopia. The myopic group had significantly less subretinal fluid at baseline (145.1 ± 74.4 µm vs. 193.6 ± 113.1 µm, P = 0.039), but more frequent photoreceptor outer segment (OS) elongation (86.8% vs. 64.3%, P = 0.031) and mottled FAF (55.3% vs. 21.4%, P = 0.010). In contrast, the non-myopic group more often showed hyper or hyper/hypo FAF. Slightly greater BCVA improvement was observed in the non-myopic group (-0.14 ± 0.26 vs. -0.03 ± 0.18, P = 0.031). Multivariate analysis identified OS elongation and mottled FAF as independent predictors of both myopic cCSC (P = 0.049 and P = 0.005, respectively) and more myopic refractive status (P < 0.001 and P = 0.005, respectively).

Myopic cCSC is associated with less subretinal fluid, more photoreceptor outer segment elongations and mottled FAF. Post-treatment BCVA improvement was slightly greater in non-myopic eyes.