Demography, Clinical Characteristics and Long-Term Outcomes of Central Serous Chorioretinopathy in Women. MICRoN Report Number Fourteen

Purpose: To evaluate the characteristics and longitudinal outcomes of chronic central serous chorioretinopathy (CSCR) in women compared to an age-matched cohort of men with CSCR. Design: Retrospective, multicenter clinical cohort study from the Macula Society CSCR Study Group. Participants: This study included 426 eyes (213 women and 213 age-matched men) with a diagnosis of CSCR. Methods: Baseline and final best-recorded visual acuity (BRVA) and multimodal imaging parameters such as area of retinal pigment epithelium (RPE) alterations, choroidal macular thickness (CMT), sub-foveal choroidal thickness (SFCT), subretinal fluid (SRF), pigment epithelium detachment (PED), double layer sign (DLS), hyperreflective dots (HRD), as well as the presence of choroidal neovascularization (CNV) and subretinal hyperreflective material (SHRM) were assessed. Regression analysis was used to evaluate baseline predictors of final visual acuity. Main outcome measures: Longitudinal changes in BRVA and imaging parameters in men and women stratified for age; factors affecting subretinal fluid (SRF) persistence, and change in BRVA. Results: A total of 426 eyes (213 women and 213 age-matched men) with CSCR were analyzed. Women showed better BRVA at presentation (0.25 ± 0.24 vs 0.31 ± 0.35 logMAR; P = .05), and exhibited smaller areas of RPE alterations (2.37 ± 2.64 vs 1.59 ± 1.55 disc areas; P = .003), less frequent peripapillary RPE changes (13.6% vs 7.5%; P < .001), shorter DLS (1353.9 ± 970.2 vs 1071.6 ± 888.7 µm; P = .039), and smaller PEDs (644.9 ± 546.4 vs 442.1 ± 278.9 µm; P = .022). During follow-up, women exhibited higher rates of complete SRF resolution (P = .001) while persistence and the number of recurrences were significantly more common in men (P = .006 and P = .02, respectively). Logistic regression analysis revealed that persistent SRF was independently associated with complex CSCR, male gender, baseline PROS irregularities, worse BRVA, SHRM, and CNV, while PDT was protective. Conclusion: Women had better visual outcomes and more favorable structural evolution while men tended to present with more complex anatomical alterations and experience higher rates of persistent SRF.