Predictors of Good Visual Recovery in Patients With Spontaneously Resolved Acute CSCR – MICRoN Report Number Thirteen

Purpose: This study investigated factors that lead to failure to achieve 20/20 visual acuity (VA) in patients with spontaneously-resolved acute CSCR. Design: Multicenter retrospective observational cohort study METHODS: In this study, data were collected from 189 patients with first episode, spontaneously resolved acute CSCR in collaboration with the Macula Society CSCR Study Group (MICRoN). Patients were categorized based on post-resolution best-recorded visual acuity (BRVA) as better or worse than 20/20. Demographic characteristics and multimodal imaging features were analyzed to identify pertinent baseline biomarkers. Multivariate logistic regression identified several factors that were associated with <20/20 VA after resolution. Results: This study included 195 eyes (189 patients), of whom 108 eyes (55.38%) achieved ≥20/20 VA and 87 (44.62%) demonstrated <20/20 VA. The mean age of patients was 45.45 ± 10.84 years, and 139 (73.54%) were males. Multivariate logistic regression showed older age (OR = 1.07, 95% CI: 1.03-1.11; P = .001), poor baseline VA (OR = 1.37, 95% CI: 1.15-1.63; p < .001), absence of serous pigment epithelial detachment (PED) (OR = 0.30, 95% CI: 0.09-0.95; P = .040) and bilaterality (OR = 4.12, 95% CI: 1.33-12.74; P = .014) were independent predictors of <20/20 VA post-resolution. Conclusion: Resolution of SRF in acute CSCR does not uniformly translate into 20/20 vision. Older age, poorer baseline BRVA, absence of serous PED, and bilateral CSCR were independent predictors of failure to achieve 20/20 vision after resolution. These findings highlight the importance of careful prognostication and functional assessment in cases of acute, single-episode CSCR.