Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy

Ophthalmology. 2019 Apr;126(4):576-588. doi: 10.1016/j.ophtha.2018.12.048. Epub 2019 Jan 17.


Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC).

Design: Retrospective, longitudinal study.

Participants: A total of 133 participants (217 eyes) with chronic CSC.

Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT.

Main outcome measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit.

Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001).

Conclusions: Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Central Serous Chorioretinopathy / complications*
  • Central Serous Chorioretinopathy / diagnostic imaging
  • Central Serous Chorioretinopathy / physiopathology
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / physiopathology
  • Chronic Disease
  • Coloring Agents / administration & dosage
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green / administration & dosage
  • Longitudinal Studies
  • Macular Edema / etiology
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Optical Imaging
  • Photography
  • Retinal Degeneration / etiology
  • Retinal Degeneration / physiopathology
  • Retrospective Studies
  • Vision Disorders / diagnostic imaging
  • Vision Disorders / etiology
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology*


  • Coloring Agents
  • Indocyanine Green