A recent study published in the Journal of VitreoRetinal Diseases suggests a new clinical, step-wise decision-making tool may help clinicians distinguish between central serous chorioretinopathy (CSR) and neovascular AMD.

The investigation reported some of the key factors mainly associated with CSR were age—70 years old or younger—and subfoveal choroidal thickness that was 300mm or greater.

The observational study included 56 eyes of 56 patients who had a new diagnosis of CSR, wet AMD, or indeterminate presentation. All patients underwent clinical assessment, axial length measurement, enhanced-depth imaging OCT and intravenous fluorescein angiography.

The researchers found subfoveal choroidal thickness was greater in the CSR group (421±106µm) than the wet AMD group (219±91µm).

Additional factors for the clinical decision-making algorithm were based on when an odds ratio reached statistical significance in CSR patients, including the following:

  • Patients who were 70 and younger
  • Subfoveal choroidal thickness greater than or equal to 300µm
  • Dome-shaped neurosensory detachment
  • Retinal pigment epithelial changes
  • Subretinal hyperreflective material
  •  Fibrovascular pigment epithelial detachment

Grewal PS, Lapere SRJ, Rudnisky CJ, et al. Distinguishing central serous chorioretinopathy from neovascular age-related macular degeneration: a prospective study. J Vitreoretin Dis. 2020;4(4)20.