Comparison of Visual Acuity and Retinal Imaging Findings in Acute and Chronic Central Serous Chorioretinopathy: A Cross-Sectional Study
Abstract
Background: Central serous chorioretinopathy (CSCR) is a pachychoroid-spectrum macular disorder characterized by serous neurosensory retinal detachment and retinal pigment epithelial dysfunction. Acute CSCR usually has a favourable visual course, whereas chronic CSCR is associated with persistent retinal pigment epithelial changes and structural retinal damage. Objectives: To compare best-corrected visual acuity and retinal imaging findings between acute and chronic CSCR in a cross-sectional hospital-based cohort. Methods: This cross-sectional study included 100 patients diagnosed with CSCR at Rajiv Gandhi Institute of Medical Sciences, Adilabad, Telangana, India, from September 2025 to February 2026. One eye per patient was analysed. Patients were classified as acute CSCR or chronic CSCR based on symptom duration and clinical-imaging features. Best-corrected visual acuity was recorded in logMAR units. Optical coherence tomography, fluorescein angiography, and fundus autofluorescence findings were compared between groups. Results: Among 100 patients, 56 had acute CSCR and 44 had chronic CSCR. The mean age was 39.8 +/- 8.6 years, and 72.0% were males. Mean best-corrected visual acuity was poorer in chronic CSCR than in acute CSCR (0.55 +/- 0.24 vs. 0.32 +/- 0.18 logMAR). Chronic CSCR showed higher frequencies of retinal pigment epithelial irregularity, pigment epithelial detachment, ellipsoid zone disruption, diffuse retinal pigment epithelial leakage, descending tract changes, and fundus autofluorescence abnormalities. Acute CSCR showed higher central macular thickness and more frequent focal leakage patterns. Conclusion: Chronic CSCR was associated with poorer visual acuity and greater structural retinal damage than acute CSCR. Multimodal retinal imaging is useful for differentiating disease chronicity and identifying vision-threatening retinal alterations. Recommendations: Routine multimodal imaging and timely management are recommended to detect chronic CSCR and protect vision.