Skip to main content

Clinical characteristics of central serous chorioretinopathy in patients by age



To investigate the clinical characteristics of central serous chorioretinopathy (CSC) with age.

Study design

Retrospective, cross-sectional study.


One-hundred and forty-seven CSC patients were classified into three age groups (aged <50 years (younger group; n=53), 50–70 years (middle group; n=68), and >70 years (senior group; n=26)) and the characteristics were compared. Bilateral ophthalmic evaluation included the best corrected visual acuity (BCVA), spherical equivalents, fundus examination, fundus autofluorescence, optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography.


The male/female ratio became lower at more advanced ages (P=0.011). Bilateral macular abnormalities were observed more frequently in the senior group than the other groups (p=0.018) and multiple drusen were characteristic in the senior group (p<0.0001). The more advanced age groups displayed a worse BCVA (P=0.002). The rate of eyes with flat retinal pigment epithelium (RPE) elevation on OCT was significantly higher in the middle group than the other groups (P=0.024). The mean subfoveal choroidal thickness (SCT) was thickest in the younger group (P<0.0001). Unifocal leakage on FA and choroidal vascular hyperpermeability were mostly found in eyes of the younger group (P<0.001,P=0.020).


CSC cases in those aged >70 years were associated with an increased proportion of women and having bilateral macular abnormalities, multiple drusen, and multifocal leakage sites. The BCVA and the SCT decreased with age. Patients with CSC aged 50–70 years had the highest rate of flat RPE elevation on OCT. These characteristics need to be considered to make an accurate diagnosis, particularly in elderly patients.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and treatment, vol. 1. St. Louis, MO: Mosby; 1997. p. 52–70.

    Google Scholar 

  2. 2.

    Guyer DR, Yannuzzi LA, Slakter JS, Sorenson JA, Ho A, Orlock D. Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol. 1994;112:1057–62.

    CAS  Article  Google Scholar 

  3. 3.

    Iida T, Kishi S, Hagimura N, Shimizu K. Persistent and bilateral choroidal vascular abnormalities in central serous chorioretinopathy. Retina. 1999;19:508–12.

    CAS  Article  Google Scholar 

  4. 4.

    Maruko I, Iida T, Sugano Y, Ojima A, Sekiryu T. Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy. Retina. 2011;31:1603–8.

    Article  Google Scholar 

  5. 5.

    Kuroda S, Ikuno Y, Yasuno Y, Nakai K, Usui S, Sawa M, et al. Choroidal thickness in central serous chorioretinopathy. Retina. 2013;33:302–8.

    Article  Google Scholar 

  6. 6.

    Cheung CMG, Lee WK, Koizumi H, Dansingani K, Lai TYY, Freund KB. Pachychoroid disease. Eye (Lond). 2019;33:14–33.

    Article  Google Scholar 

  7. 7.

    Yanagi Y. Pachychoroid disease: a new perspective on exudative maculopathy. Jpn J Ophthalmol. 2020;64:323–7.

    Article  Google Scholar 

  8. 8.

    Yannuzzi LA. Type-A behavior and central serous chorioretinopathy. Retina. 1987;7:111–31.

    CAS  Article  Google Scholar 

  9. 9.

    Schatz H, Madeira D, Johnson RN, McDonald HR. Central serous chorioretinopathy occurring in patients 60 years of age and older. Ophthalmology. 1992;99:63–7.

    CAS  Article  Google Scholar 

  10. 10.

    Spaide RF, Campeas L, Haas A, Yannuzzi LA, Fisher YL, Guyer DR, et al. Central serous chorioretinopathy in younger and older adults. Ophthalmology. 1996;103:2070–80.

    CAS  Article  Google Scholar 

  11. 11.

    Spaide RF, Hall L, Haas A, Campeas L, Yannuzzi LA, Fisher YL, et al. Indocyanine green videoangiography of older patients with central serous chorioretinopathy. Retina. 1996;16:203–13.

    CAS  Article  Google Scholar 

  12. 12.

    Bae K, Nam SW, Kang SW, Kim ES, Yu SY, Kim KT, et al. Central serous chorioretinopathy in elderly subjects: angiographic and tomographic characteristics. Graefes Arch Clin Exp Ophthalmol. 2019;257:279–88.

    Article  Google Scholar 

  13. 13.

    Fung AT, Yannuzzi LA, Freund KB. Type 1 (sub-retinal pigment epithelial) neovascularization in central serous chorioretinopathy masquerading as neovascular age-related macular degeneration. Retina. 2012;32:1829–37.

    Article  Google Scholar 

  14. 14.

    Maruko I, Iida T, Saito M, Nagayama D, Saito K. Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol. 2007;144:15–22.

    Article  Google Scholar 

  15. 15.

    Yannuzzi LA, Freund KB, Goldbaum M, Scassellati-Sforzolini B, Guyer DR, Spaide RF, et al. Polypoidal choroidal vasculopathy masquerading as central serous chorioretinopathy. Ophthalmology. 2000;107:767–77.

    CAS  Article  Google Scholar 

  16. 16.

    Toyama T, Ohtomo K, Noda Y, Ueta T. Polypoidal choroidal vasculopathy and history of central serous chorioretinopathy. Eye (Lond). 2014;28:992–7.

    CAS  Article  Google Scholar 

  17. 17.

    Spaide RF. Disease expression in nonexudative age-related macular degeneration varies with choroidal thickness. Retina. 2018;38:708–16.

    Article  Google Scholar 

  18. 18.

    Zweifel SA, Spaide RF, Curcio CA, Malek G, Imamura Y. Reticular pseudodrusen are subretinal drusenoid deposits. Ophthalmology. 2010;117:303–12.

    Article  Google Scholar 

  19. 19.

    Sasahara M, Tsujikawa A, Musashi K, Gotoh N, Otani A, Mandai M, et al. Polypoidal choroidal vasculopathy with choroidal vascular hyperpermeability. Am J Ophthalmol. 2006;142:601–7.

    Article  Google Scholar 

  20. 20.

    Araki T, Ishikawa H, Iwahashi C, Niki M, Mitamura Y, Sugimoto M, et al. Central serous chorioretinopathy with and without steroids: a multicenter survey. PloS One. 2019;14:e0213110.

    CAS  Article  Google Scholar 

  21. 21.

    Goto S, Gomi F, Ueno C, Nishida K. Reduced-fluence photodynamic therapy for subfoveal serous pigment epithelial detachment with choroidal vascular hyperpermeability. Am J Ophthalmol. 2012;154:865–71.

    Article  Google Scholar 

  22. 22.

    Takahashi A, Ooto S, Yamashiro K, Tamura H, Oishi A, Miyata M, et al. Pachychoroid geographic atrophy: clinical and genetic characteristics. Ophthalmol Retina. 2018;2:295–305.

    Article  Google Scholar 

  23. 23.

    Yamashiro K, Hosoda Y, Miyake M, Takahashi A, Ooto S, Tsujikawa A. Hypothetical pathogenesis of age-related macular degeneration and pachychoroid diseases derived from their genetic characteristics. Jpn J Ophthalmol. 2020;64:555–67.

    CAS  Article  Google Scholar 

  24. 24.

    Oshima Y, Ishibashi T, Murata T, Tahara Y, Kiyohara Y, Kubota T. Prevalence of age related maculopathy in a representative Japanese population: the Hisayama study. Br J Ophthalmol. 2001;85:1153–7.

    CAS  Article  Google Scholar 

  25. 25.

    Takahashi A, Hosoda Y, Miyake M, Miyata M, Oishi A, Tamura H, et al. Clinical and genetic characteristics of pachydrusen in eyes with central serous chorioretinopathy and general Japanese individuals. Ophthalmol Retina. 2020.

    Article  PubMed  Google Scholar 

  26. 26.

    Cheung CMG, Gan A, Yanagi Y, Wong TY, Spaide RF. Association between choroidal thickness and drusen subtypes in age-related macular degeneration. Ophthalmol Retina. 2018;2:1196–205.

    Article  Google Scholar 

  27. 27.

    Matsumoto H, Mukai R, Morimoto M, Tokui S, Kishi S, Akiyama H. Clinical characteristics of pachydrusen in central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2019;257:1127–32.

    CAS  Article  Google Scholar 

  28. 28.

    Mitarai K, Gomi F, Tano Y. Three-dimensional optical coherencetomographic findings in central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2006;244:1415–20.

    Article  Google Scholar 

  29. 29.

    Fujimoto H, Gomi F, Wakabayashi T, Sawa M, Tsujikawa M, Tano Y. Morphologic changes in acute central serous chorioretinopathy evaluated by fourier-domain optical coherence tomography. Ophthalmology. 2008;115:1494–500.

    Article  Google Scholar 

  30. 30.

    Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy. Retina. 2013;33:1659–72.

    Article  Google Scholar 

  31. 31.

    Pang CE, Freund KB. Pachychoroid neovasculopathy. Retina. 2015;35:1–9.

    CAS  Article  Google Scholar 

  32. 32.

    Hage R, Mrejen S, Krivosic V, Quentel G, Tadayoni R, Gaudric A. Flat irregular retinal pigment epithelium detachments in chronic central serous chorioretinopathy and choroidal neovascularization. Am J Ophthalmol. 2015;159:890–903.

    Article  Google Scholar 

  33. 33.

    Quaranta EI, Maftouhi M, Maftouhi AE, Eandi CM. Chronic central serous chorioretinopathy imaged by optical coherence tomographic angiography. Am J Ophthalmol. 2015;160:581–7.

    Article  Google Scholar 

  34. 34.

    Dansingani KK, Balaratnasingam C, Klufas MA, Sarraf D, Freund KB. Optical coherence tomography angiography of shallow irregular pigment epithelial detachments in pachychoroid spectrum disease. Am J Ophthalmol. 2015;160:1243–54.

    Article  Google Scholar 

  35. 35.

    Ikuno Y, Kawaguchi K, Nouchi T, Yasuno Y. Choroidal thickness in healthy Japanese subjects. Invest Ophthalmol Vis Sci. 2010;51:2173–6.

    Article  Google Scholar 

  36. 36.

    Wakatsuki Y, Shinojima A, Kawamura A, Yuzawa M. Correlation of aging and segmental choroidal thickness measurement using swept source optical coherence tomography in healthy eyes. PloS One. 2015;10:e0144156.

    Article  Google Scholar 

  37. 37.

    Regatieri CV, Novais EA, Branchini L, Adhi M, Cole ED, Louzada R, et al. Choroidal thickness in older patients with central serous chorioretinopathy. Int J Retina Vitreous. 2016;15:2–22.

    Google Scholar 

Download references


This study was supported by a grant from the Japan Society for the Promotion of Science (19K09963). We thank Robert Blakytny, DPhil, from Edanz ( for editing a draft of this manuscript.

Author information



Corresponding author

Correspondence to Fumi Gomi.

Ethics declarations

ConflictS of interest

C. Tanaka, None; C. Iwahashi, None; Y. Komuku, None; K. Hozumi, None; K. Mitarai, None; F. Gomi, None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Corresponding Author: Fumi Gomi

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tanaka, C., Iwahashi, C., Komuku, Y. et al. Clinical characteristics of central serous chorioretinopathy in patients by age. Jpn J Ophthalmol (2021).

Download citation


  • Central serous chorioretinopathy
  • Senior
  • Drusen
  • Choroidal thickness
  • Retinal pigment epithelium