Central serous choroidopathy in patients over 50 years of age

Reviewing all records of patients with the diagnosis of central serous choroidopathy (CSC) at Retina Consultants, Ltd since 1975, we identified 47 patients with CSC who were older than 50 years at initial presentation. These patients were divided into three groups, based on type of management: observation; light ''CSC-type'' photocoagulation; and heavy ''subretinal-neovascular-membrane (SRNVM)-type'' photocoagulation. Although most of these patients retained excellent central visual acuity, overall final visual acuities were poorer than those in other reported series. Heavier photocoagulation, as compared with lighter treatment, was associated with a decreased incidence of posttreatment SRNVM formation and appeared to have no adverse effect on final visual outcome. Patients with multiple irregular leaks on fluorescein angiography had a greater tendency to develop SRNVMs, with or without treatment. Ophthalmologists diagnosing CSC in patients over age 50 should be aware that there is a greater risk of SRNVM developing in these patients.