Clinical variations and outcomes of central serous chorioretinopathy in Black and White patients: MICRoN report-16.

PURPOSE: To compare baseline characteristics and outcomes of central serous chorioretinopathy (CSCR) between people who identify as Black and those who identify as White.

METHODS

This retrospective, multicenter study from the MICRoN study group, included Black and White patients with CSCR. Demographic information and multimodal imaging parameters were analyzed and compared in the two groups. Regression models were used to identify factors affecting visual outcomes, anatomical changes, and disease recurrence/persistence.

RESULTS

We included a total of 450 patients (312 males and 138 females), of whom 100 were Black patients, and 350 were White patients. Black patients were significantly older (51.9 versus 48.8 years, p=0.03) but had shorter symptom duration at presentation (1 versus 3 months, p=0.003). They demonstrated worse baseline visual acuity (0.3±0.3 versus 0.2±0.2 logMAR, p<0.001), greater retinal detachment height (157.9 versus 107.5 μm, p=0.002), and more frequent peripapillary retinal pigment epithelium changes (27% versus 9.4%, p<0.001). During a median follow-up of 24 months (IQR 10 to 60 months), White patients experienced significantly higher rates of disease recurrence (35.7% versus 19%, p=0.002), persistent subretinal fluid (13.1% versus 4%, p=0.01), and macular neovascularization development (21.1% versus 4%, p<0.001). Multivariable regression confirmed that Black patients were associated with reduced recurrence risk (OR 0.52, p=0.03).

CONCLUSIONS

Despite presenting with more severe morphological changes and worse initial vision, Black patients demonstrate substantially lower rates of recurrences and sequelae, suggesting biological differences in disease pathophysiology.