Clinical Characteristics and Multimodal Imaging Findings of Central Serous Chorioretinopathy in Women versus Men

Abstract

(1) The aim of this study was to compare the clinical characteristics and multimodal imaging findings of central serous chorioretinopathy (CSCR) between women and men. (2) Women and men with CSCR were compared in terms of their age and risk factors, the clinical form of their disease, multimodal imaging findings and the presence of macular neovascularization (MNV) on optical coherence tomography (OCT)-angiography. (3) Results: The data of 75 women and 75 men were compared. The women were significantly older than the men (52.2 years versus 45.7 years; p < 0.001). Corticosteroid intake was more frequent in the women (56% versus 40%; p = 0.05). The women had a single foveal subretinal detachment more often than the men (73.3% versus 46.9%; p < 0.001) and they often had fewer gravitational tracks (16.3% versus 29.6%; p = 0.03). On mid-phase indocyanine green angiography, hyperfluorescent plaques were detected less often in the women than in the men (48% versus 72.2%, p = 0.001). MNV was detected on OCT-angiography in 35.9% of the women and in 13.3% of the men (p = 0.004). (4) In the women, CSCR occurs at an older age, is more often unifocal foveolar, and is associated with a higher rate of MNV. The reasons for these gender-related differences remain to be determined.

Keywords: central serous chorioretinopathy; epitheliopathy; gravitational tracks; macular neovascularization; pachychoroid neovasculopathy; women.

Figure 1

(A,B) Central serous chorioretinopathy (CSCR) with a unifocal macular serous retinal detachment (SRD). (A) Blue-light fundus autofluorescence (BAF) shows no signs of previous extra-macular SRD. (B) The OCT B-scan shows a macular SRD. (C,E) CSCR with multifocal SRD.(C) BAF shows a mixed multifocal round area of hyper/hypo-autofluorescence consistent with an active or resolved SRD. (D,E) The OCT B-scan passing through the round hyper-autofluorescent area shows subretinal detachments located superior to the fovea (D) and inferior to the optic disc (E).

Figure 2

Multimodal imaging of a 34-year-old woman with central serous chorioretinopathy in the left eye. (A) Blue-light fundus autofluorescence shows a mixed hyper- and hypo-autofluorescent area at the macular serous retinal detachment (SRD). (B,C) The horizontal (B) and vertical (C) enhanced-depth-imaging (EDI)-OCT scans centered on the fovea show a macular SRD associated with dilated choroidal vessels (stars). (D) OCT-angiography at the level of the choriocapillaris shows no macular neovascularization. (E) Late-phase fluorescein angiography (FA) shows one focal leak (arrow). Insert: early-phase FA showing the focal leak (arrow). (F) Early-phase indocyanine green angiography (ICGA) shows dilated macular choroidal veins magnified in the insert. (G) Mid-phase ICGA shows multifocal hyperfluorescent plaques (arrrowheads).