Type 1 (sub-retinal pigment epithelial) neovascularization in central serous chorioretinopathy masquerading as neovascular age-related macular degeneration

Retina. 2012 Oct;32(9):1829-37. doi: 10.1097/IAE.0b013e3182680a66.


Purpose: The purpose of this study was to describe clinical and multimodal imaging features of patients with Type 1 neovascularization who lack findings of age-related macular degeneration but instead have features consistent with long-standing central serous chorioretinopathy (CSC).

Methods: Nonconsecutive, retrospective, observational case series. Two groups of patients were identified and analyzed. Group 1 included patients presenting with Type 1 neovascularization who at the time of diagnosis were found to have findings more consistent with long-standing CSC than age-related macular degeneration. Group 2 included patients with a known history of CSC who developed Type 1 neovascularization over their course of follow-up. Clinical histories and multimodal imaging findings (color and red-free photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral domain optical coherence tomography, and enhanced depth imaging optical coherence tomography) were analyzed.

Results: Twenty-seven eyes of 22 patients were identified. Thirteen patients presented with Type 1 neovascularization thought to be secondary to CSC (Group 1), and 9 patients with CSC were observed to develop Type 1 neovascularization over their course of follow-up (Group 2). Eight patients (36%) had polypoidal neovascular structures within their Type 1 neovascular lesions, of which 4 (18% of all patients) had bilateral Type 1 neovascularization. The mean age of patients was 61 years (range, 48-76 years), and the median age was 58.5 years. Thirteen patients (59%) were men. For those patients in Group 2, the mean duration between diagnosis of CSC and detection of Type 1 neovascularization was 139 months (range, 7-365 months). The mean subfoveal choroidal thickness was 354 μm (range, 186-666 μm).

Conclusion: Some patients presenting with Type 1 neovascularization may have clinical and multimodal imaging findings more consistent with long-standing CSC than with age-related macular degeneration. These patients are more likely to be younger, men, have thicker choroids, and have a higher prevalence of polypoidal neovasculopathy than those patients with Type 1 neovascularization secondary to age-related macular degeneration. Proper identification of these patients may have implications for their natural course and management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Central Serous Chorioretinopathy / complications
  • Central Serous Chorioretinopathy / diagnosis*
  • Coloring Agents
  • Diagnosis, Differential
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green
  • Male
  • Middle Aged
  • Retinal Neovascularization / complications
  • Retinal Neovascularization / diagnosis*
  • Retinal Pigment Epithelium / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Wet Macular Degeneration / diagnosis*


  • Coloring Agents
  • Indocyanine Green