Association of Serum Uric Acid With Choroidal Thickness in Chronic Central Serous Chorioretinopathy: A Retrospective Exploratory Cohort Study

Background To investigate associations between systemic biomarkers and quantitative choroidal phenotype in chronic central serous chorioretinopathy (cCSC), and to determine whether baseline serum uric acid (UA) is associated with early anatomical or functional recovery after subthreshold micropulse laser (SML). Methods This retrospective exploratory cohort included 47 patients with cCSC. Baseline blood testing comprised routine metabolic markers, blood-cell-derived inflammatory indices, and circulating cytokines. Best-corrected visual acuity (BCVA), contrast sensitivity (logCS), central macular thickness (CMT), subretinal fluid (SRF), central 0-3-mm choroidal vascularity index (CVI), and central 0-3-mm choroidal thickness (SCT) were assessed at baseline, day 7, and day 30. Baseline biomarker-SCT screening used age- and sex-adjusted linear regression with HC3 robust standard errors and Benjamini-Hochberg false-discovery-rate (FDR) correction. Early recovery models evaluated follow-up outcomes as a function of baseline UA while adjusting for the corresponding baseline ocular value, age, and sex; FDR correction was applied across 12 UA-follow-up tests. Results Mean age was 42.4 ± 5.7 years and 38/47 participants were men. UA was the only screened biomarker associated with baseline SCT after FDR correction (adjusted β = -0.840 µm per µmol/L, 95% CI -1.254 to -0.426; P < 0.001; q = 0.0023). At day 30, higher baseline UA was nominally associated with greater residual CMT (β = 30.5 µm per 100 µmol/L, 95% CI 4.8 to 56.3; P = 0.0199), but the association did not survive FDR correction (q = 0.239). The corresponding association with day-30 SRF was directionally similar but non-significant (β = 26.6 µm per 100 µmol/L; P = 0.064). No robust UA association was observed with BCVA, logCS, CVI, SCT, or complete SRF resolution. Conclusions Higher serum UA was associated with a thinner baseline central choroid in this exploratory cCSC cohort, but UA did not show robust evidence as an early SML response predictor. These findings support a potential systemic metabolic-choroidal relationship while emphasizing the distinction between baseline phenotype and treatment response. Trial registration: Not applicable.