Central serous chorioretinopathy (CSCR) is generally considered self-limiting, with spontaneous resolution of subretinal fluid (SRF) occurring in most patients within 3 to 4 months. However, visual recovery does not always correspond to anatomical improvement, and factors associated with incomplete visual recovery in spontaneously resolved acute CSCR remain incompletely defined. This study evaluated baseline clinical and multimodal imaging factors associated with failure to achieve 20/20 visual acuity after spontaneous SRF resolution.

The study included 195 eyes of 189 patients, with 108 eyes (55.38%) achieving ≥20/20 vision and 87 (44.62%) remaining below 20/20 after resolution. Multivariate analysis identified bilateral CSCR (OR, 4.12), older age (OR, 1.07), worse baseline visual acuity (OR, 1.37 per 0.1-logMAR increase), and absence of serous pigment epithelial detachment (OR, 0.30)…