Abstract
PURPOSE: To assess prevalence and associations of active central serous chorioretinopathy (CSC) and inactive CSC/pachychoroid pigment epitheliopathy (PPE) in a general population aged 50+ years. METHODS: Using optical coherent tomographic images, we assessed CSC lesions in participants of the population-based Beijing Eye Study. We differentiated between active CSC with subretinal fluid, and inactive CSC/PPE with retinal pigment epithelium irregularities and dilated large choroidal vessels and without subretinal fluid. RESULTS: Out of 6551 eyes, CSC/PPE was detected in 98 eyes (70 participants; 60 (86%) men) (prevalence: 1.5%; 95%CI: 1.1, 1.9), with active CSC (with/without inactive CSC/PPE) in 52 eyes (53%) and inactive CSC/PPE (with/without an active component) in 66 eyes (67%). CSC location was only foveal in 21 (21%) eyes, only extrafoveal in 44 (45%) eyes, and mixed in 33 (34%) eyes. CSC occurred bilaterally in 28 patients (56 (57%) eyes). Both eyes of all CSC patients (also those with unilateral CSC) showed markedly dilated large choroidal vessels. CSC lesion number ranged between 1 and 13 (mean:2.5 ± 2.2) per eye. Higher CSC prevalence was associated with younger age (OR: 0.95; 95%CI: 0.91, 0.99; P = 0.01), male sex (OR: 4.16; 95% CI: 1.92, 9.02; P < 0.001), thicker subfoveal choroid (OR: 1.004; 95% CI: 1.001, 1.007; P = 0.01), and higher prevalences of retinal outer nuclear layer thinning (OR: 4.08; 95% CI: 1.25, 13.3; P = 0.02), intraretinal hyperreflective foci (iHRFs) beyond the ellipsoid zone (OR: 7.11; 95% CI: 3.21, 15.8; P < 0.001), macular hypopigmentations (OR: 1.55; 95% CI: 1.30, 1.85; P < 0.001), and incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) (OR: 12.3; 95% CI: 2.97, 51.1; P < 0.001). CONCLUSIONS: Active CSC and inactive CSC/PPE together were relatively frequent in a general population consisting of Han Chinese from the Beijing region and aged 50+ years. They occurred often multifocal and were often extrafoveally located.