Objective To describe fundus autofluorescence (FAF) and optical coherence tomography (OCT) patterns in central serous chorioretinopathy (CSC) and correlate them with the stage of disease as well as the prognosis for visual acuity.Methods In this cross-sectional study,70 eyes of 67 patients with CSC underwent FAF imaging and spectral-domain OCT scans,and routine ophthalmologic examinations as well.The pattern of fundus alterations in various stages of disease detected by FAF and OCT,and their correlation with best corrected visual acuity (BCVA) were evaluated and analyzed.Data were analyzed using a rank-sum test.Results FAF and OCT images showed correlated but not identical findings that were classified into four phenotypic patterns: ①Normal type: 7 eyes (10％) displayed no abnormal FAF signal with consistent OCTs showing the upward arch bulge of the neurosensory layer,separated from the retinal pigment epithelium (RPE),with a dark liquid zone underneath.The outer segments of the photoreceptor layer were intact and flat,and uniformly distributed.②HyperFAF type:observed in 32 eyes (45.7％).Among them,28 eyes (88％) had neurosensory layer detachment (SRD).The FAF imaging mainly displayed an increased presence of fluorophores within the SRD area,while OCT demonstrated uneven processes at the surface of the outer segment band.Twenty eyes (62％) contained granules of hyperFAF that basically correlated with the yellowish-white dots seen in the retina,and highly reflective granule-like processes in the outer segment band or the surface of the RPE layer in OCT.③HypoFAF type:observed in 9 eyes (13％),all with SRD.OCT imaging revealed an intact and flat outer segment band that was uniformly distributed.④Mixed type: alternation of hyper- and hypoautofluorescence,observed in 22 eyes (31％).Seventeen of those eyes (77％) displayed regular FAF,normally appearing as hypoFAF surrounding hyperFAF.OCT displayed the arch bulge of the neurosensory layer,with a dark liquid zone underneath.The corresponding outer segment band of the hypoFAF region was smooth and flat,with highly reflective granule-like processes in the hyperFAF region.There were significant difference between all other groups including Normal AF/hypo AF,hyperAF,regular mixed AF and irregular mixed AF (Z=5.380,-3.791,-3.416,-4.049,-3.309,-3.421,P＜0.01).For the corresponding BCVA,there were statistically significant differences between all types (Z=-3.792,-2.676,-2.790,-3.128,-3.311,P＜0.01),except for the difference between the hyperFAF type and the regular mixed type (Z=-2.012,P＜0.05).Conclusion In the early stages of acute CSC,FAF might display normal or decreased autofluorescence.Over time,there was a time-dependent progressive increase in the intensity of FAF.HypoFAF was known to occur in correlation with atrophy that results from a chronic detachment of the retina in patients with chronic and persistent CSC.In areas with altered FAF,SD-OCT imaging revealed marked morphological abnormalities not only of the RPE cell layer but also of the photoreceptor layer.Poor visual prognosis correlated most strongly with the long-term course of the disease.Thereafter,prompt management is highly recommended for treatment of CSC.