Scholarlink

Background <p>Serous Maculopathy Due to Aspecific Choroidopathy (SMACH) is a rare chorioretinal disease characterized by polymorphic, non-pigmented choroidal lesions, with or without subretinal fluid (SRF). Its clinical manifestations overlap with common conditions such as central serous chorioretinopathy (CSC) and age-related macular degeneration (AMD), leading to a high risk of misdiagnosis, particularly in elderly patients. Multimodal imaging, including optical coherence tomography (OCT), OCT angiography (OCTA), fluorescein fundus angiography (FFA), and indocyanine green angiography (ICGA), is critical for accurate diagnosis.</p> Case presentation <p>A 76-year-old Asian female presented with a 6-month history of blurred vision in her left eye. Ophthalmic examination revealed multiple yellowish-white subretinal lesions with mild elevation in the posterior pole of the left eye. OCT and OCTA demonstrated hyperreflective fibrinous exudates between the retinal pigment epithelium (RPE) and Bruch’s membrane, choroidal thickening, and outer retinal damage. Fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) provided complementary findings consistent with choroidal dysfunction and blood-retinal barrier disruption. Systemic evaluations, including laboratory tests for rheumatological immune indicators, tuberculin test, syphilis serology, and imaging examinations, excluded other systemic diseases. Based on these multimodal imaging findings and exclusion of alternative diagnoses, the patient was diagnosed with SMACH.</p> Conclusions <p>This case report describes a typical presentation of SMACH in an elderly patient, emphasizing that multimodal imaging, as demonstrated in this case, can help identify characteristic features of SMACH (choroidal thickening, hyperreflective exudates), though its diagnostic reliability in larger populations requires further validation.The exclusion of systemic diseases and differentiation from similar chorioretinal disorders (e.g., CSC, AMD) are crucial for accurate diagnosis.This case adds to the existing limited data on SMACH in elderly populations and further supports the role of multimodal imaging in improving diagnostic accuracy to reduce misdiagnosis.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Serous Maculopathy due to Aspecific Choroidopathy (SMACH): a case report with differential diagnosis based on multimodal imaging analysis

  • 期刊论文

  • 发表日期：

    2026年6月15日

查看全文
  • Xuan Ren,
  • Xinxin Yu,
  • Shuai Huang,
  • Xiangkun Qi,
  • Shiwu Wang,
  • Yan Sun

摘要

Background

Serous Maculopathy Due to Aspecific Choroidopathy (SMACH) is a rare chorioretinal disease characterized by polymorphic, non-pigmented choroidal lesions, with or without subretinal fluid (SRF). Its clinical manifestations overlap with common conditions such as central serous chorioretinopathy (CSC) and age-related macular degeneration (AMD), leading to a high risk of misdiagnosis, particularly in elderly patients. Multimodal imaging, including optical coherence tomography (OCT), OCT angiography (OCTA), fluorescein fundus angiography (FFA), and indocyanine green angiography (ICGA), is critical for accurate diagnosis.

Case presentation

A 76-year-old Asian female presented with a 6-month history of blurred vision in her left eye. Ophthalmic examination revealed multiple yellowish-white subretinal lesions with mild elevation in the posterior pole of the left eye. OCT and OCTA demonstrated hyperreflective fibrinous exudates between the retinal pigment epithelium (RPE) and Bruch’s membrane, choroidal thickening, and outer retinal damage. Fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) provided complementary findings consistent with choroidal dysfunction and blood-retinal barrier disruption. Systemic evaluations, including laboratory tests for rheumatological immune indicators, tuberculin test, syphilis serology, and imaging examinations, excluded other systemic diseases. Based on these multimodal imaging findings and exclusion of alternative diagnoses, the patient was diagnosed with SMACH.

Conclusions

This case report describes a typical presentation of SMACH in an elderly patient, emphasizing that multimodal imaging, as demonstrated in this case, can help identify characteristic features of SMACH (choroidal thickening, hyperreflective exudates), though its diagnostic reliability in larger populations requires further validation.The exclusion of systemic diseases and differentiation from similar chorioretinal disorders (e.g., CSC, AMD) are crucial for accurate diagnosis.This case adds to the existing limited data on SMACH in elderly populations and further supports the role of multimodal imaging in improving diagnostic accuracy to reduce misdiagnosis.