Visual acuity correlates with multimodal imaging-based categories of central serous chorioretinopathy (Oct, 10.1038/s41433-021-01788-4, 2021)

Objective: To evaluate visual acuity (VA) and factors influencing VA using new multimodal imaging-based classification of central serous chorioretinopathy (CSCR). Methods: Retrospective, observational and cross-sectional study on 229 naïve eyes diagnosed as CSCR with available baseline data and multimodal imaging. Each case was classified into (i) simple/complex/atypical; (ii) primary/recurrent/resolved; (iii) persistent or not; (iv) outer retinal atrophy(ORA) present/absent; (v) foveal involvement present/absent; and (vi) macular neovascularization(MNV) present/absent. Best corrected visual acuity (BCVA) was correlated to the classification as well as every parameter of the classification. Results: Median BCVA was 0.18 logMAR [95% Confidence Interval (CI)0.16–0.18] with median duration of complaints of one month (95% CI,6.14–13.0 months). Age of the patient (r = −0.24, p = 0.002) and duration of the disease (r = −0.32, p < 0.001) correlated significantly with BCVA. Logistic regression model showed that older age [odds ratio (OR) = 0.96, p = 0.05], female gender (OR = 2.45, p = 0.046), presence of ORA(OR = 0.34, p = 0.012),and foveal involvement(OR = 0.18, p = 0.007) were statistically significantly associated with poorer BCVA. Eyes classified as complex, persistent CSCR, with ORA or foveal involvement demonstrated lower BCVA compared to those with simple, non-persistent CSCR, without ORA or without foveal involvement (p < 0.05). Eyes with complex CSCR (p < 0.001), atypical CSCR(p = 0.025), persistent subretinal fluid (SRF) (p = 0.001) and those with ORA (p < 0.001) demonstrated a trend towards severe visual loss. Prevalence of persistent SRF, recurrent episodes and ORA was significantly higher among eyes with complex CSCR (p < 0.001) while there was no difference in prevalence of resolved cases (p = 0.07), foveal involvement (p = 0.28) and MNV (p = 0.45) between simple and complex cases. Conclusion: There is a strong correlation between VA and foveal involvement and ORA using the new classification. Thus, the objective parameters of the classification can be incorporated in establishing the treatment guidelines for CSCR. © 2021, The Author(s), under exclusive licence to The Royal College of Ophthalmologists.