Importance of OCT-derived Biomarkers for the Recurrence of Central Serous Chorioretinopathy using Statistics and Predictive Modelling

Abstract Central serous chorioretinopathy (CSCR) is a posterior segment disease characterized by accumulation of subretinal fluid that, in acute forms, resolves spontaneously. However, about a third of the cases experience recurrences that might cause severe and irreversible vision loss due to anatomical outer retinal and retinal pigment epithelium changes. This study aims to identify optical coherence tomography (OCT)-derived parameters linked to CSCR recurrence. Our dataset included 5211 OCTs from 344 eyes of 255 CSCR patients. After expert labeling, 178 eyes were identified as recurrent, 109 were non-recurrent, and 57 were excluded. We extracted parameters using artificial intelligence and computer vision. We used inferential statistics to assess differential distribution between the recurrent and non-recurrent groups, and we employed predictive modeling for feature importance analysis. We identified 9 predictive biomarkers for CSCR recurrence, including age, presence of subretinal fluid, intraretinal fluid and Pigment Epithelial detachments, as well as choroidal vascularity index, integrity of photoreceptors and RPE layer, thicknesses of choriocapillaris and choroidal stroma, and thinning of internal retinal layers (outer nuclear layer, and inner nuclear layer combined with and outer plexiform layer). These results can potentially enable future developments in automatic detection of CSCR recurrence, paving the way for translational medical applications.