Clinical Features and Outcomes of Bullous Central Serous Chorioretinopathy: A Multicentric Cohort Study

Purpose: To evaluate the clinical features, systemic associations, and outcomes of the bullous variant of central serous chorioretinopathy (bvCSC) through a multicentric study. Methods: A retrospective analysis was conducted on patients diagnosed with bvCSC across five tertiary eye centers. Demographic data, visual acuity (VA), treatment modalities, and follow-up outcomes were analyzed. A literature review was performed to contextualize findings. Results: The study included 35 eyes from 25 patients (80% male), with a mean age of 47.7 ± 12.2 years. Systemic comorbidities were identified in 60% of patients. Baseline VA was 1.18 ± 0.89 logMAR. Serous retinal detachment resolved in 63% of eyes, but persistent subretinal fibrosis contributed to limited visual recovery. Treatment varied, with observation (37%) being the most common approach, followed by systemic eplerenone (17%) and focal laser (13%). Available data did not show a clear advantage of any treatment modality. Conclusion: The bullous variant of central serous chorioretinopathy is frequently associated with systemic conditions and has a guarded visual prognosis despite anatomical resolution in most cases. The study underscores the importance of early diagnosis and a tailored treatment to optimize outcomes in this severe CSC variant.