Journals / Balıkesir Sağlık Bilimleri Dergisi / 2026 / Volume: 14 Issue: 1

Autonomic Pupillary Light Response in Central Serous Chorioretinopathy

Santral Seröz Koryoretinopati'de Otonom Pupil Işık Yanıtı

Durgül Açan(BALIKESIR UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-9944-9902
Yurdagül Girgin(BALIKESIR UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-1653-2955
Eyup Karahan(BALIKESIR UNIVERSITY, SCHOOL OF MEDICINE)0000-0003-2099-1991
Pages
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Publication Date
2025-03-28
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This suggests that systemic hormonal factors and local choroidal responses, rather than sympathetic activation, should be prioritized in understanding the pathophysiology of CSCR.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The aim of the study is to evaluate the autonomic nervous system (ANS) activity by assessing static and dynamic pupillary light responses in central serous chorioretinopathy (CSCR).
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Key Findings & Data:Thirty eyes of 30 patients with CSCR who were previously diagnosed in our clinic were included in the study group, and 31 right eyes of 31 healthy participants were included in the control group.
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Conclusion & Impact:This suggests that systemic hormonal factors and local choroidal responses, rather than sympathetic activation, should be prioritized in understanding the pathophysiology of CSCR.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Autonomic Nervous System · Central Serous Chorioretinopathy · Pupillary Reflex

Abstract

Objective: The aim of the study is to evaluate the autonomic nervous system (ANS) activity by assessing static and dynamic pupillary light responses in central serous chorioretinopathy (CSCR). Materials and Methods: A case-control study. Thirty eyes of 30 patients with CSCR who were previously diagnosed in our clinic were included in the study group, and 31 right eyes of 31 healthy participants were included in the control group. All participants underwent a complete ophthalmologic examination. Static and dynamic pupillometry values were measured with the Scheimpflug/Placido photo-based topography system, Sirius topographer (CSO, Firenze, Italy) and pupillary dilation velocities were calculated and compared between the groups. Results: The mean scotopic, mesopic, photopic pupil diameters as well as scotopic/photopic ratios were not statistically different in the study and control groups, with values of 4.98±0.87 mm vs. 5.05±0.98 mm, 3.86±0.82 mm vs. 3.86±0.83 mm, 2.94±0.60 mm vs. 2.87±0.57 mm and 1.72±0.20 vs. 1.77±0.22, respectively (p1=0.759, p2=0.997, p3=0.676, p4=0.304). Dynamic pupillometric values were also similar between the groups (p>0.05). Pupillary dilatation velocity was slower in the study group during the 2-4 second interval (p=0.013). Conclusion: Pupillary responses mediated by the ANS in CSCR patients are similar to those of healthy participants. This suggests that systemic hormonal factors and local choroidal responses, rather than sympathetic activation, should be prioritized in understanding the pathophysiology of CSCR.

Özet

Amaç: Çalışmanın amacı santral seröz korioretinopatide (SSKR) statik ve dinamik pupil ışık yanıtlarını değerlendirerek otonom sinir sistemi (OSS) aktivitesini değerlendirmektir. Gereç ve Yöntem: Bir vaka-kontrol çalışması. Kliniğimizde daha önce tanı almış 30 SSKR hastasının 30 gözü çalışma grubuna, 31 sağlıklı katılımcının 31 sağ gözü ise kontrol grubuna dahil edildi. Tüm katılımcılara tam bir oftalmolojik muayene yapıldı. Statik ve dinamik pupillometre değerleri Scheimpflug/Placido foto-tabanlı topografi sistemi, Sirius topografı (CSO, Floransa, İtalya) ile ölçüldü ve pupil dilatasyon hızları hesaplandı ve gruplar arasında karşılaştırıldı. Bulgular: Çalışma ve kontrol gruplarında ortalama skotopik, mezopik, fotopik pupil çapları ve skotopik/fotopik oranlar istatistiksel olarak farklı değildi; sırasıyla 4,98±0,87 mm ile 5,05±0,98 mm, 3,86±0,82 mm ile 3,86±0,83 mm, 2,94±0,60 mm ile 2,87±0,57 mm ve 1,72±0,20 ile 1,77±0,22 idi (p1=0,759, p2=0,997, p3=0,676, p4=0,304). Dinamik pupillometrik değerler de gruplar arasında benzerdi (p>0,05). Çalışma grubunda pupil dilatasyon hızı 2-4 saniyelik aralıkta daha yavaştı (p=0,013). Sonuç: SSKR hastalarında OSS tarafından yönetilen pupilla yanıtları sağlıklı katılımcıların yanıtlarına benzerdir. Bu, SSKR'nin patofizyolojisini anlamada sempatik aktivasyondan ziyade sistemik hormonal faktörler ve lokal koroidal yanıtların önceliklendirilmesi gerektiğini düşündürmektedir.

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Cite This Article

Açan, D., Girgin, Y., Karahan, E. (2025). Autonomic Pupillary Light Response in Central Serous Chorioretinopathy. Balıkesir Sağlık Bilimleri Dergisi, Volume: 14 Issue: 1. https://doi.org/10.53424/balikesirsbd.1613770

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References (17)

  1. Cankurtaran, V., Ozates, S., Ozler, S. (2019). Association of pupil responses with severity of erectile dysfunction in diabetes mellitus. Indian Journal of Ophthalmology, 67(8), 1314-1319. http://doi.org/10.4103/ijo.IJO_220_19.
  2. Feenstra, H.M.A., van Dijk, E.H.C., Cheung, C.M.G., et al. (2024). Central serous chorioretinopathy: An evidence-based treatment guideline. Progress in Retinal and Eye Research, 101, 101236. http://doi.org/10.1016/j.preteyeres.2024.101236.
  3. Gibbons, C.H. (2019). Basics of autonomic nervous system function. Handbook of Clinical Neurology, 160, 407-418. http://doi.org/10.1016/B978-0-444-64032-1.00027-8.
  4. Hwang, B.E., Kim, J.Y., Park, Y.H. (2024). The effect of heart rate variability on the choroidal vascularity of the optical coherence tomography and angiography in central serous chorioretinopathy. Graefes Archieve for Clinical and Experimental Ophthalmology, 262(12), 3825-3835. http://doi.org/10.1007/s00417-024-06575-x.
  5. Jain, M., Devan, S., Jaisankar, D., Swaminathan, G., Pardhan, S., Raman, R. (2018). Pupillary abnormalities with varying severity of diabetic retinopathy. Scientific Reports, 8, 5636. http://doi.org/10.1038/s41598-018-24015-9.
  6. Koizumi, H., Imanaga, N., Terao, N. (2024). Central serous chorioretinopathy and the sclera: what we have learned so far. Japanese Journal of Ophthalmology, 68(5), 419-428. http://doi.org/10.1007/s10384-024-01101-2.
  7. Leclercq, B., Weiner, A., Zola, M., et al. (2023). The choroidal nervous system: a link between mineralocorticoid receptor and pachychoroid. Acta Neuropathologica, 146(5), 747-766. http://doi.org/10.1007/s00401-023-02628-3.
  8. Maumenee, A.E. (1965). Macular diseases: Clinical manifestations. Transactions-American Academy of Ophthalmology and Otolaryngology, 69, 605-613.
  9. McDougal, D.H., Gamlin, P.D. (2015). Autonomic control of the eye. Comprensive Physiology, 5(1), 439-473. http://doi.org/10.1002/cphy.c140014.
  10. Min, J.Y., Lv, Y., Yu, S., Gong, Y.Y. (2018). Findings of oct-angiography compared to fluorescein and indocyanine green angiography in central serous chorioretinopathy. Lasers in Surgery and Medicine, 50, 987–993. http://doi.org/10.1002/lsm.22952.
  11. O’Connor, D.B., Thayer, J.F., Vedhara, K. (2021). Stress and health: a review of psychobiological processes. Annual Review of Psychology, 72, 663–688. http://doi.org/10.1146/annurev-psych-062520-122331.
  12. Prakash, G., Srivastava, D., Suhail, M., Bacero, R. (2016). Assessment of bilateral pupillary centroid characteristics at varying illuminations and post‐photopic flash response using an automated pupillometer. Clinical and Experimental Optometry 99, 535‑543. http://doi.org/10.1111/cxo.12409.
  13. Scarinci, F., Ghiciuc, C.M., Patacchioli, F.R., Palmery, M., Parravano, M. (2019). Investigating the hypothesis of stress system dysregulation as a risk factor for central serous chorioretinopathy: A literature mini-review. Current Eye Research, 44(6), 583-589. http://doi.org/10.1080/02713683.2019.1565891.
  14. Tewari, H.K., Gadia, R., Kumar, D., Venkatesh, P., Garg, S.P. (2006). Sympathetic-parasympathetic activity and reactivity in central serous chorioretinopathy: a case-control study. Investigative Ophthalmology and Visual Science, 47(8), 3474-3478. http://doi.og/10.1167/iovs.05-1246.
  15. Venkata, Sivakumar, A., Kalburgi-Narayana, M., Kuppusamy, M., Ramaswamy, P., Bachali, S. (2020). Computerized dynamic pupillometry as a screening tool for evaluation of autonomic activity. Neurophysiologie Clinque, 50(5), 321-329. http://doi.org/10.1016/j.neucli.2020.09.004.
  16. Zhang, X., Lim, C.Z.F., Chhablani, J., Wong, Y.M. (2023). Central serous chorioretinopathy: updates in the pathogenesis, diagnosis and therapeutic strategies. Eye and Vision (Lond), 10(1), 33. http://doi.og/10.1186/s40662-023-00349-y.
  17. Zhou, X., Fukuyama, H., Okita, Y., et al. (2022). Pupillary responses reveal autonomic regulation impairments in patients with central serous chorioretinopathy. Investigative Ophthalmology and Visual Science, 63(10), 2. http://doi.og/10.1167/iovs.63.10.2.