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Short axial length and hyperopic refractive error are risk factors of central serous chorioretinopathy
  1. Nobuhiro Terao1,
  2. Hideki Koizumi2,
  3. Kentaro Kojima1,
  4. Natsuki Kusada1,
  5. Kenji Nagata1,
  6. Tetsuya Yamagishi1,
  7. Kazuhito Yoneda1,
  8. Kengo Yoshii3,
  9. Shigeru Kinoshita4,
  10. Chie Sotozono1
  1. 1Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  2. 2Ophthalmology, University of the Ryukyus, Nakagami-gun, Okinawa, Japan
  3. 3Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
  4. 4Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  1. Correspondence to Professor Hideki Koizumi, Ophthalmology, University of the Ryukyus, Nakagami-gun, Okinawa 903-0125, Japan; hkoizumi{at}


Background/aims To evaluate the axial length (AL) and refractive status in central serous chorioretinopathy (CSC).

Methods This retrospective observational case series involved 140 patients with CSC (180 eyes) and 78 age-matched and gender-matched control subjects. A detailed ophthalmic examination was performed, including an interferometer measurement of AL. Multimodal imaging comprised colour fundus photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence photography and spectral domain optical coherence tomography.

Results Eighty eyes of 40 patients were categorised into the bilateral-CSC (b-CSC) group and 100 eyes of 100 patients were categorised into the unilateral-CSC (u-CSC) group. AL of the b-CSC (23.19 mm) and u-CSC (23.75 mm) groups was significantly shorter than that of the control (24.85 mm) group (p<0.001 for both). Moreover, AL was significantly shorter in the b-CSC group than in the u-CSC group (p=0.020). Spherical equivalent (SE) in the b-CSC (0.25 D) group was significantly greater than in the u-CSC (−0.81 D) and control (−1.38 D) groups (p<0.001 for both). Gender (male; OR 4.55; 95% CI 1.13 to 18.40; p=0.033), AL (OR 0.38; 95% CI 0.23 to 0.63; p<0.001), area of choroidal vascular hyperpermeability (OR 1.08; 95% CI 1.03 to 1.13; p=0.002) and presence of descending tract (OR 7.22; 95% CI 1.86 to 28.00; p=0.004) were the variables found to be significantly associated with b-CSC via multiple regression analyses.

Conclusion Anatomical features, such as shorter AL and greater SE, may be associated with the pathogenesis of CSC.

  • central serous chorioretinopathy
  • axial length
  • spherical equivalent
  • choroidal vascular hyperpermeability
  • descending tract

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  • Contributors NK and HK: involved in design and conduct of the study; NT, KK, NK, KN, TY and KY: collection; NT: management; NT, HK and KY: analysis and interpretation of the data; NT: preparation, NT, HK and KK: review; NT, HK, KK, SK and CS: approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the institutional review board of the Kyoto Prefectural University of Medicine. The procedures were conducted in accordance with the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.