SUBRETINAL EXUDATIVE DEPOSITS IN CENTRAL SEROUS CHORIORETINOPATHY

The presence of subretinal exudation in a patient with neurosensory de tachment of the macula frequently suggests the diagnosis of choroidal neovascularisation. A retrospective chart review of newly diagnosed ca ses of central serous chorioretinopathy revealed 11 patients, seven me n and four non-pregnant women, who had plaques of subretinal exudate, which presumably were fibrin. Each of these patients had a solitary pl aque that ranged in size from 300 to 1500 mum in diameter. These patie nts had no signs or a clinical course suggestive of choroidal neovascu larisation. In each case the subretinal plaque was overlying an exuber ant leak in the retinal pigment epithelium. The exudate was generally present at the initial examination, and usually showed dissolution bef ore or coincident with the resolution of the neurosensory detachment. After resolution of the central serous chorioretinopathy, patients wer e left with subtle alterations in the retinal pigment epithelium in th e areas of the subretinal plaque. These findings are important for two reasons. Firstly, the presence of subretinal exudation does not neces sarily rule out the diagnosis of central serous chorioretinopathy. Sec ondly, pathophysiological theories of central serous chorioretinopathy must explain how the plaques are deposited behind the retina.