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Prevalence and associations of central serous chorioretinopathy in a population aged 50+ years. The Beijing Eye Study

Eye (2026)Cite this article

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Abstract

Purpose

To assess prevalence and associations of active central serous chorioretinopathy (CSC) and inactive CSC/pachychoroid pigment epitheliopathy (PPE) in a general population aged 50+ years.

Methods

Using optical coherent tomographic images, we assessed CSC lesions in participants of the population-based Beijing Eye Study. We differentiated between active CSC with subretinal fluid, and inactive CSC/PPE with retinal pigment epithelium irregularities and dilated large choroidal vessels and without subretinal fluid.

Results

Out of 6551 eyes, CSC/PPE was detected in 98 eyes (70 participants; 60 (86%) men) (prevalence: 1.5%; 95%CI: 1.1, 1.9), with active CSC (with/without inactive CSC/PPE) in 52 eyes (53%) and inactive CSC/PPE (with/without an active component) in 66 eyes (67%). CSC location was only foveal in 21 (21%) eyes, only extrafoveal in 44 (45%) eyes, and mixed in 33 (34%) eyes. CSC occurred bilaterally in 28 patients (56 (57%) eyes). Both eyes of all CSC patients (also those with unilateral CSC) showed markedly dilated large choroidal vessels. CSC lesion number ranged between 1 and 13 (mean:2.5 ± 2.2) per eye. Higher CSC prevalence was associated with younger age (OR: 0.95; 95%CI: 0.91, 0.99; P = 0.01), male sex (OR: 4.16; 95% CI: 1.92, 9.02; P < 0.001), thicker subfoveal choroid (OR: 1.004; 95% CI: 1.001, 1.007; P = 0.01), and higher prevalences of retinal outer nuclear layer thinning (OR: 4.08; 95% CI: 1.25, 13.3; P = 0.02), intraretinal hyperreflective foci (iHRFs) beyond the ellipsoid zone (OR: 7.11; 95% CI: 3.21, 15.8; P < 0.001), macular hypopigmentations (OR: 1.55; 95% CI: 1.30, 1.85; P < 0.001), and incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) (OR: 12.3; 95% CI: 2.97, 51.1; P < 0.001).

Conclusions

Active CSC and inactive CSC/PPE together were relatively frequent in a general population consisting of Han Chinese from the Beijing region and aged 50+ years. They occurred often multifocal and were often extrafoveally located.

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Data availability

All data are available upon reasonable request from the corresponding author.

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Funding

National Natural Science Foundation of China (82271086). The funder of this study had no role in study design, data collection, data analysis, data interpretation, or writing of the manuscript.

Author information

Author notes

  1. These authors contributed equally: Jost B. Jonas, Songhomitra Panda-Jonas.

Authors and Affiliations

  1. Rothschild Foundation Hospital, Institut Français de Myopie, Paris, France

    Jost B. Jonas

  2. Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore

    Jost B. Jonas

  3. Privatpraxis Prof Jonas und Dr. Panda-Jonas, Heidelberg, Germany

    Jost B. Jonas & Songhomitra Panda-Jonas

  4. Beijing Visual Science and Translational Eye Research Institute (BERI), Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, China

    Jost B. Jonas & Ya Xing Wang

  5. L V Prasad Eye Institute, Hyderabad, Telangana, India

    Jost B. Jonas

  6. Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Sha Tin, Hong Kong

    Jost B. Jonas

  7. New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jost B. Jonas & Ya Xing Wang

  8. Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany

    Songhomitra Panda-Jonas

  9. Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China

    Jie Xu

  10. Department of Ophthalmology, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany

    Rahul A. Jonas

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  1. Jost B. Jonas
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  2. Songhomitra Panda-Jonas
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Corresponding author

Correspondence to Ya Xing Wang.

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Competing interests

SP-J, RAJ, JBJ: European patent EP 3 271 392, JP 2021-119187, and U.S. Patent No. US 12,024,557 B2: “Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; European patent application 23196899.1”. EGFR Antagonists for the treatment of diseases involving unwanted migration, proliferation, and metaplasia of RPE cells.

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Jonas, J.B., Panda-Jonas, S., Xu, J. et al. Prevalence and associations of central serous chorioretinopathy in a population aged 50+ years. The Beijing Eye Study. Eye (2026). https://doi.org/10.1038/s41433-026-04269-8

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