PURPOSE To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC). DESIGN Retrospective, longitudinal study. PARTICIPANTS A total of 133 participants (217 eyes) with chronic CSC. METHODS A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT. MAIN OUTCOME MEASURES Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit. RESULTS Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001). CONCLUSIONS Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.

中文翻译：

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慢性中央性浆液性脉络膜视网膜病变的长期视觉结果和视力丧失原因。

目的评估慢性中央性浆液性脉络膜脉络膜视网膜病变（CSC）的长期视觉效果和视力丧失的原因。设计回顾性纵向研究。参与者共有133名参与者（217眼）患有慢性CSC。方法回顾性回顾1977年5月至2018年3月由3位作者管理的慢性CSC患者的临床和多模式影像学数据。多模式影像学包括彩色摄影，荧光素血管造影，吲哚菁绿色血管造影，眼底自发荧光（FAF）和OCT。主要观察指标最终访视时的最佳矫正视力（BCVA）；第一次就诊与1年，5年和10年随访之间BCVA的变化；以及最终访视时视力下降的原因。结果分析了6228例个体门诊的数据。初次就诊患者的平均年龄为60岁。7年，从第一次到最后一次随访的平均随访时间为11.3年。该队列包括101名男性患者（75.9％）。在最后一次就诊时，至少有1眼有106例患者（79.7％）保持驾驶标准视力且BCVA为20/40或更好，而合法盲的17例患者（12.8％）的BCVA为20/200或更差眼睛。初诊时的平均BCVA与1或5年随访时的平均BCVA均无显着差异（均P≥0.65），但明显优于10年随访时的平均BCVA（P = 0.04） ）。第一次随访时有79％的视力达到20/40或更好的眼睛在10年的随访期中保持了相同的视力水平。第一次随访时有92％视力为20/200或更差的眼睛在10年的随访期中保持了相同的视力水平。最终访视时，黄斑囊样变性，脉络膜新生血管（CNV），OCT上的外部视网膜破坏和FAF变化与视力差相关（所有P≤0.001）。多变量分析显示，首次随访时的年龄较大与10年随访时的BCVA变化较大有关（P = 0.001）。结论慢性CSC可能是威胁视力的疾病，导致法律上的失明。呈现时的年龄和多模式影像学上的外部视网膜变化与长期BCVA变化相关，并且可能是长期视觉结果的预测指标。多变量分析显示，首次随访时的年龄较大与10年随访时的BCVA变化较大有关（P = 0.001）。结论慢性CSC可能是威胁视力的疾病，导致法律上的失明。呈现时的年龄和多模式影像学上的外部视网膜变化与长期BCVA变化相关，并且可能是长期视觉结果的预测指标。多变量分析显示，首次随访时的年龄较大与10年随访时的BCVA变化较大有关（P = 0.001）。结论慢性CSC可能是威胁视力的疾病，导致法律上的失明。呈现时的年龄和多模式影像学上的外部视网膜改变与长期BCVA变化有关，并且可能是长期视觉结果的预测指标。