Ultra-Wide-Field Optical Coherence Tomography Assessment of Choroidal Parameters in Central Serous Chorioretinopathy

Purpose: To analyze choroidal thickness (CT) and choroidal volume (CV) using ultra-wide-field (UWF) spectral-domain optical coherence tomography (SD-OCT) in patients with central serous chorioretinopathy (CSC) and to assess their associations with disease duration and best-corrected visual acuity (BCVA). Methods: This prospective case–controlled study included 50 eyes of 41 CSC patients and 56 eyes of 32 healthy controls matched for age and sex. CT was measured at 24 points using the REVO 130 UWF SD-OCT device with a wide-field adapter, covering a 21 × 21 mm retinal area across central, mid-peripheral (4 mm), and peripheral (8 mm) zones. CV was estimated using a quadratic nonlinear model. ROC curve analysis and univariate logistic regression were applied to evaluate discriminative capacity and odds ratios (OR) for CT and CV. Results: CT was significantly higher in CSC eyes at all 24 measurement points (all p < 0.0001). Mean subfoveal CT was 472.6 µm vs. 344.8 µm in controls (+37%), with greater relative increases at mid-peripheral (+46%) and peripheral (+44%) zones. Mean CV was 61.47 (±11.37) mm3 vs. 42.29 (±10.02) (+45%; p < 0.0001). CV showed a higher OR for CSC occurrence than central CT (OR = 2.88; 95% CI: 1.53–5.42 vs. OR = 1.04; 95% CI: 1.02–1.07). Significant discriminative CT points (AUC > 0.60) clustered at the 2/8, 4/10, and 6/12 clock meridians. Both CT and CV correlated positively with disease duration (Spearman rho 0.35–0.41; p ≤ 0.0004) but not with BCVA. Conclusions: UWF SD-OCT confirms diffuse pachychoroid thickening in CSC extending to the periphery. CV is a sensitive biomarker in association with CSC status. Peripheral CT and CV correlate with disease duration, supporting the link between higher volumetric choroidal values and longer disease course. Integration of these parameters may improve CSC diagnosis and prognostic evaluation.