Optical density ratio as a prognostic biomarker for chronicity in Central Serous Chorioretinopathy

Purpose: To evaluate the prognostic significance of baseline subretinal fluid (SRF) optical density ratio (ODR) in first-onset Central Serous Chorioretinopathy (CSCR). Methods: This retrospective study included patients with a new diagnosis of CSCR, no prior retinal disease, and at least 3 months of follow-up. Eyes were categorized as resolved or non-resolved based on SRF resolution at 3 months. ODR was calculated as the ratio between SRF and vitreous optical densities on baseline OCT scans. Results: Thirty-nine patients (33 men, 6 women; mean age 41.4 ± 9.1 years) met inclusion criteria. At 3 months, SRF resolved in 19 eyes and persisted in 20 eyes. Baseline ODR was significantly higher in the non-resolved group compared with the resolved group (1.03 ± 0.32 vs. 0.80 ± 0.27; p = 0.018). Visual acuity at follow-up was significantly better in the resolved group (20/21.4 [logMAR 0.03 ± 0.05] vs. 20/26.4 [logMAR 0.12 ± 0.16]; p = 0.035). No significant differences were found between groups in age, sex, or choroidal thickness. In multivariate logistic regression, ODR remained the only independent predictor of SRF persistence at 3 months. Conclusion: Baseline ODR is associated with both fluid persistence and visual outcomes. As the only independent predictor of persistent SRF in this cohort, ODR shows promise as a potential prognostic biomarker requiring no additional cost to identify patients at higher risk for chronic disease at initial presentation.