Guzide AKCAY, Ulviye KIVRAK, Dilber Celik YAPRAK, Omer Faruk BOGAZLIYAN, Neslihan BUYUKMURAT
İstanbul Kuzey Klinikleri Dergisi - 2026;13(3):274-279
OBJECTIVE: This study aimed to investigate potential subclinical structural and microvascular changes in the clinically unaffected fellow eyes of patients with acute central serous chorioretinopathy (aCSC) and to compare these findings with age- and sex-matched healthy controls. METHODS: In this retrospective study, the fellow eyes of 33 aCSC patients and one randomly selected eye from 40 healthy controls were analyzed. Central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT), and subfoveal choroidal thickness (SFCT) were measured using optical coherence tomography (OCT). OCT angiography was performed to assess vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris plexus (CCP), and peripapillary capillary plexus (PPCP), as well as the foveal avascular zone. RESULTS: No differences were observed in mean CMT or RNFLT between fellow eyes of aCSC patients (faCSC) and controls; however, superior and inferior macular quadrants were significantly thicker in faCSC eyes (p=0.005 and p=0.007, respectively). SFCT was markedly increased in faCSC eyes compared to controls (333.2+/-93.16 µm vs. 239.8+/-34.27 µm; p<0.001). While SCP and DCP VDs did not differ significantly, CCP VD was elevated in the foveal, superior, inferior, and temporal regions of faCSC eyes (p<0.001-p=0.005). PPCP VD was also higher in the superior and temporal quadrants (p=0.02 and p=0.01). CONCLUSION: Clinically, faCSC patients demonstrate increased SFCT, regional macular thickening, and elevated VD in both CCP and PPCP. These findings indicate that CSC is not exclusively a localized retinal disorder but may involve systemic and bilateral choroidal changes. Early subclinical alterations in the fellow eye highlight the importance of careful monitoring for timely intervention and prevention of disease progression.
