Postreceptor Neural Loss in Patients With Chronic Central Serous Chorioretinopathy

Purpose: To investigate the relationship between ganglion cell layer (GCL) thickness and photoreceptor alterations in eyes with resolved chronic central serous chorioretinopathy (CSC). Design: Retrospective, cross-sectional “case-control” comparison study. Methods: We collected data from 70 eyes from 70 male individuals with chronic CSC, pachychoroid pigment epitheliopathy, and healthy controls. Optical coherence tomography imaging was used to assess ellipsoid zone (EZ) reflectivity as a marker of photoreceptor integrity and GCL thickness as an indicator of inner retinal loss. Normalized EZ reflectivity and GCL thickness were compared among groups, and a regression analysis was performed to evaluate the relationship between photoreceptor damage and inner retinal thinning. Results: CSC eyes exhibited significantly reduced EZ reflectivity compared to pachychoroid pigment epitheliopathy and healthy controls (P < .05). GCL thickness was also reduced in CSC eyes, particularly in the ETDRS inner ring. A significant association was found between EZ reflectivity and GCL thickness in CSC patients (P = .046), suggesting a link between photoreceptor and ganglion cell loss. Conclusions: Photoreceptor damage in chronic CSC is associated with inner retinal thinning, supporting the hypothesis of postreceptor neural loss. These findings provide further insights into the broader retinal involvement in CSC and may have implications for visual function in affected patients.