CLINICAL AND IMAGING PREDICTORS OF BILATERAL INVOLVEMENT IN CENTRAL SEROUS CHORIORETINOPATHY

This research investigated the risk factors and multimodal imaging characteristics associated with the onset of central serous chorioretinopathy (CSCR) in the contralateral eye during follow-up of patients initially presenting with unilateral complex CSCR.

In this retrospective cohort, patients observed between 2015 and 2023 were classified into two groups: those progressing from unilateral to bilateral CSCR formed the study group, whereas patients who did not develop contralateral disease during follow-up comprised the control group. Demographic characteristics and smoking status were recorded. Multimodal imaging was documented.

A total of 126 eyes from 63 patients were evaluated, including 31 with bilateral disease (Group 1) and 32 with unilateral CSCR (Group 2). In Group 1, the mean interval between involvement of the first and second eye was 21.29 ± 18.46 months. At baseline, the mean subfoveal choroidal thickness in affected eyes was 293 ± 67 µm in the study group, significantly lower than the 356 ± 64 µm observed in controls (P < 0.001). Multivariate regression analysis demonstrated that smoking, the presence of CSCR-related changes in the fellow eye on initial fundus fluorescein angiography (FFA), and reduced choroidal thickness in the first affected eye were independent predictors of bilateral disease progression.

The findings indicate that smoking, early CSCR-related changes in the contralateral eye on baseline FFA, and reduced choroidal thickness in the initially affected eye represent significant risk factors for bilateral CSCR development.