Autonomic Pupillary Light Response in Central Serous Chorioretinopathy

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.