Comparison between thin and thick choroid eyes in central serous chorioretinopathy

While central serous chorioretinopathy (CSCR) is typically associated with pachychoroid, a subset of patients presents with thin choroids. This study aims to compare the clinical features of CSCR in thin versus thick choroid eyes.

In this retrospective multicenter study, patients were categorized by subfoveal choroidal thickness (SFCT) into thin (≤250 µm) and thick (≥400 µm) groups. Multimodal imaging was used to analyze central macular thickness (CMT), SFCT, neurosensory detachment height (NSRD-h), Haller vessel thickness (HVT), and inner choroidal thickness (ICT) at baseline and final visit.

Among 355 eyes, 52 (14.6%) had thin and 303 (85.4%) had thick choroids. Thin choroid patients were older (p<0.001) and more often female (38.5% vs. 23.1%,p=0.019). Visual acuity was similar at baseline (0.30 Log Minimum Angle of Resolution (logMAR), Snellen equivalent [20/40]) vs. 0.22 [20/33], p=0.38) and final follow-up (0.18 logMAR [Snellen equivalent [20/30] vs. 0.15 [20/28], p=0.08). CMT decreased in both groups, but SFCT, HVT, and ICT remained stable in the thin group. Spontaneous resolution and recurrence rates were similar; however, choroidal neovascularization (CNV) development was significantly higher in the thin choroid group (p=0.003).

Thin-choroid CSCR represents a distinct clinical phenotype with older age, and female predominance. Although CNV occurred more frequently in this group compared to the thick choroid group, multivariate analysis indicates that age may be a key contributor to CNV risk.