Choriocapillaris flow deficits and choroidal vascular index in the fellow eye of patients with central serous chorioretinopathy

Purpose To evaluate choroidal changes in the fellow eyes of patients with chronic central serous chorioretinopathy (CSCR). Methods A retrospective study was conducted on 50 participants, including 25 patients with unilateral chronic CSCR and 25 age-matched healthy controls. Optical coherence tomography (OCT) enhanced depth imaging (EDI) and OCT-angiography (OCT-A) images were processed using ImageJ, and three parameters were analyzed: flow deficit (FD), subfoveal choroidal thickness (SFCT), and choroidal vascular index (CVI). Results CSCR eyes had significantly higher SFCT (320.9 ± 59.5), FD (54.2 ± 9.2), and CVI (52.8 ± 18.2) compared to healthy controls (SFCT 263.8 ± 66.6; FD 43.9 ± 9.9; CVI 22.6 ± 11.8). No significant differences were found between CSCR and fellow eyes, but fellow eyes showed higher values (SFCT 296.6 ± 51.9; FD 44.5 ± 6.3; CVI 46.5 ± 20.3) than healthy controls. ANOVA confirmed group differences, with post-hoc tests showing CSCR eyes differed significantly from healthy controls. Pearson’s analysis found positive correlations for SFCT but inconsistent correlations between FD and CVI, limiting reliability. Conclusions This study confirms choroidal vascular changes in both CSCR and fellow eyes, suggesting their role in pathogenesis and a possible genetic or environmental predisposition. These findings may help improve diagnosis, prognosis, and risk assessment in patients with CSCR.