摘要： PURPOSE. To quantitatively evaluate the pulse waveform changes in macular choroidal blood ?ow by using laser speckle ?owgraphy (LSFG) with regression of acute central serous chorioretinopathy (CSC). METHODS. This retrospective observational case series included 20 eyes of 20 patients with acute CSC. Laser speckle ?owgraphy was performed at baseline and after 6 months. On the LSFG monochrome map, automatically divided 5 3 5 grid segments within the macula were classi?ed into predominantly delayed ?lling (PDF) or minimally or no delayed ?lling (MDF) areas according to the degree of choroidal ?lling delay on early-phase indocyanine green angiography. The average mean blur rate (MBR) and the pulse waveform parameters, including the skew and blowout time (BOT), were compared between the total PDF and MDF areas during follow-up. RESULTS. The average MBR signi?cantly decreased in both PDF (P ? 0.005) and MDF (P < 0.001) areas during follow-up; in both areas, the skew decreased (P < 0.001 and P ? 0.006, respectively) and BOT increased (P < 0.001 for each), showing signi?cant reduction in vascular resistance at 6 months. The degree of the changes in the skew and BOT was signi?cantly larger (P ? 0.02 and P < 0.001, respectively) in the PDF area than in the MDF area. CONCLUSIONS. Changes in the skew and BOT, indices for vascular resistance, con?rmed the involvement of circulatory disturbance at the acute stage of CSC. The present ?ndings suggested that the pathogenesis of CSC stems from imbalanced distribution of choroidal blood ?ow due to augmented vascular resistance.