Predictive factors for the development of macular neovascularization in chronic central serous chorioretinopathy

This single-center, retrospective study analyzed the development of macular neovascularization (MNV) in patients with chronic central serous chorioretinopathy (CSCR) during a treatment-free follow-up period and the factors associated with its development. In total, 236 patients (280 eyes, 149 males and 87 females, mean age 55.3 ± 13.9 years) with treatment-naïve CSCR with no MNV detected on multimodal imaging who were observed for > 6 months were assessed. The association between age, sex, the presence of MNV, central choroidal thickness (CCT), the presence of the double-layer sign (DLS), and the cumulative duration of the persistence of serous retinal detachment (SRD) was also analyzed to determine the visual outcome before the onset of MNV. Twenty-eight (10%) eyes developed MNV over a mean follow-up period of 48.3 ± 43.3 months. The persistence of SRD for ≥ 6 months ( p = 0.003) and presence of DLS measuring ≥ 1000 μm in length and < 100 μm in height ( p = 0.040) exhibited significant associations with the development of MNV. Furthermore, the persistence of SRD for ≥ 6 months showed a significant association with logMAR visual acuity loss of ≥ 0.3 ( p = 0.0009). Thus, the persistence of SRD for ≥ 6 months and numerically defined DLS were identified as predictors for the development of MNV in patients with CSCR.