Clinical Characteristics and Outcomes in Central Serous Chorioretinopathy With Subretinal Hyper-Reflective Material: MICRoN Report 6
Year: 2026
Type: article
Study design: Observational Study
Abstract: PURPOSE: To evaluate the clinical features and longitudinal outcomes of chronic central serous chorioretinopathy (CSCR) presenting with subretinal hyperreflective material (SHRM). DESIGN: Retrospective, multicenter clinical cohort study from the Macula Society CSCR Study Group. PARTICIPANTS: This study included consecutive patients with a diagnosis of CSCR, with and without SHRM. METHODS: Baseline and final best-recorded visual acuity (BRVA) and multimodal imaging parameters were compared between SHRM and non-SHRM groups. MAIN OUTCOME MEASURES: Longitudinal changes in BRVA and imaging parameters in both groups; factors affecting subretinal fluid (SRF) persistence, and change in BRVA. RESULTS: A total of 503 eyes (103 with SHRM and 400 eyes without SHRM) were analyzed. The SHRM group showed poorer baseline BRVA (0.4 ± 0.3 logMAR; 20/50) compared to the non-SHRM group (0.2 ± 0.3 logMAR; 20/30) (p = .006). SHRM eyes demonstrated greater RPE alteration (p = .04), higher neurosensory retinal detachment (p < .001), more photoreceptor irregularities (p = .004), hyperreflective foci (p < .001), and double-layer sign (p < .001). The incidence of concurrent macular neovascularization (p = .01) and persistent subretinal fluid (p < .001) was higher in the SHRM group. Despite visual improvement in both groups, final height of neuro-sensory detachment (p < .001) remained higher in SHRM eyes. Eyes with a history of steroid exposure and ellipsoid zone (EZ) loss (post-resolution) were greater in higher SHRM grades. Logistic regression revealed non-SHRM status, and combination therapy had lower odds of SRF persistence. CONCLUSION: CSCR with SHRM presented with worse initial vision. Although vision improved after treatment, persistent SRF and EZ loss (in resolved cases) remain more frequent in SHRM eyes.
Authors: Niroj Kumar Sahoo, Nasiq Hasan, Ninan Jacob, Jessica Cao, Charles C. Wykoff, Priya Shah, Panisa Singhanetr, Elizabeth J. Rossin, Lorenzo Ferro Desideri, Felicia Hertkorn, Marion R. Munk, Samer Khateb, Jay Wang, Rahul N. Khurana, Yusuf Ashfaq, Zachary Kroeger, Michael Zhang, Maurizio Battaglia Parodi, Gabriele Piccoli, Stela Vujosevic, Min Kim, Carmen Antía Rodríguez-Fernández, Luis Arias Barquet, Kent Small, Paisan Ruamviboonsuk, Peranut Chotcomwongse, Luiz H. Lima, Adrian T. Fung, Lihteh Wu, Jay Chhablani
Institutions: L V Prasad Eye Institute, University of Pittsburgh Medical Center, Retina Consultants of Texas, Massachusetts Eye and Ear Infirmary, Harvard University, University Hospital of Bern, Northwestern University, University of Bern, Hebrew University of Jerusalem, Hadassah Medical Center, Oregon Health & Science University, Canberra Hospital, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, MultiMedica, University of Milan, Yonsei University, Bellvitge University Hospital, Macula and Retina Institute, Rajavithi Hospital, Universidade Federal de São Paulo, The University of Sydney, Sun Yat-sen University, Westmead Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, Macquarie University, University of Pittsburgh
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,300
OpenAlex ID: W7131640447