Serous Retinal Detachment and Double-layer Sign Predict MNV in CSCR

The correlation between the presence of exudative changes, including intermittent recurrences, and the risk of developing macular neovascularization (MNV), especially in patients with chronic central serous chorioretinopathy (CSCR) who cannot receive treatment and those observed without treatment, is unclear. Researchers based in Japan believed that the development of MNV in patients with CSCR under observation without treatment may be associated with predisposing anatomical factors. Their recent retrospective study analyzed the development of MNV in patients with CSCR during a treatment-free follow-up period and the factors associated with its development. Determining the cumulative duration of the persistence of serous retinal detachment, even after its resolution, is important in the management of CSCR. Patients with cumulative duration of such detachment persistence of ≥ six months must be assessed carefully. This image from the study shows a double layer sign (yellow arrow) in a CSCR patient. Click image to enlarge. It determined that the persistence of serous retinal detachment for ≥ six months and the presence of a double-layer sign (DLS) measuring ≥ 1,000μm in length and < 100μm in height exhibited significant associations with the development of MNV. Furthermore, the persistence of SRD for ≥ six months showed a significant association with logMAR visual acuity loss of ≥ 0.3.“These findings emphasize the importance of early detection and commencement of therapeutic intervention for MNV, especially in patients with persistent and intermittent subretinal fluid accumulation,” the study authors wrote in their paper, which was published in Scientific Reports.In total, 236 patients (280 eyes, 149 males and 87 females, mean age 55.3 years) with treatment-naïve CSCR with no MNV detected on multimodal imaging who were observed for > six months were assessed. The researchers found that 28 eyes (10%) developed MNV over a mean follow-up period of 48.3 months.The researchers noted that the presence of MNV in lesions of ≥1,000μm in length and <100μm in height can be detected with high sensitivity and specificity on OCT angiography (OCT-A). However, not all cases of DLS do not contain MNV. The findings of the present study characterized DLS that did not contain MNV but were at high risk of developing MNV in patients with CSCR.“The cumulative duration of SRD and the presence of DLS, as demonstrated in our study, may reflect progressive choroidal dysfunction,” the team wrote. “Future studies integrating multimodal imaging—including OCT-A and en face analysis—will further elucidate how pachychoroid phenotypes predispose to MNV.” Click here for the journal source. Kitano M, Aoiki S, Kitamoto K, et al. Predictive factors for the development of macular neovascularization in chronic central serous chorioretinopathy. Sci Rep. 2025;15(1):32250. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.