Serous business: Delineating the broad spectrum of diseases with subretinal fluid in the macula

Elon H. C. van Dijk, Camiel J. F. Boon

Research output: Contribution to journalReview articleAcademicpeer-review

41 Citations (Scopus)

Abstract

A wide range of ocular diseases can present with serous subretinal fluid in the macula and therefore clinically mimic central serous chorioretinopathy (CSC). In this manuscript, we categorise the diseases and conditions that are part of the differential diagnosis into 12 main pathogenic subgroups: neovascular diseases, vitelliform lesions, inflammatory diseases, ocular tumours, haematological malignancies, paraneoplastic syndromes, genetic diseases, ocular developmental anomalies, medication-related conditions and toxicity-related diseases, rhegmatogenous retinal detachment and tractional retinal detachment, retinal vascular diseases, and miscellaneous diseases. In addition, we describe 2 new clinical pictures associated with macular subretinal fluid accumulation, namely serous maculopathy with absence of retinal pigment epithelium (SMARPE) and serous maculopathy due to aspecific choroidopathy (SMACH). Differentiating between these various diseases and CSC can be challenging, and obtaining the correct diagnosis can have immediate therapeutic and prognostic consequences. Here, we describe the key differential diagnostic features of each disease within this clinical spectrum, including representative case examples. Moreover, we discuss the pathogenesis of each disease in order to facilitate the differentiation from typical CSC.
Original languageEnglish
Article number100955
JournalProgress in Retinal and Eye Research
Volume84
Early online date2021
DOIs
Publication statusPublished - Sept 2021

Keywords

  • Central serous chorioretinopathy (CSC)
  • Differential diagnosis
  • Retinal disease
  • Serous fluid accumulation
  • Serous maculopathy

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