A wide range of ocular diseases can present with serous subretinal fluid in the macula and therefore clinically mimic central serous chorioretinopathy (CSC). In this manuscript, we categorise the diseases and conditions that are part of the differential diagnosis into 12 main pathogenic subgroups: neovascular diseases, vitelliform lesions, inflammatory diseases, ocular tumours, haematological malignancies, paraneoplastic syndromes, genetic diseases, ocular developmental anomalies, medication-related conditions and toxicity-related diseases, rhegmatogenous retinal detachment and tractional retinal detachment, retinal vascular diseases, and miscellaneous diseases. In addition, we describe 2 new clinical pictures associated with macular subretinal fluid accumulation, namely serous maculopathy with absence of retinal pigment epithelium (SMARPE) and serous maculopathy due to aspecific choroidopathy (SMACH). Differentiating between these various diseases and CSC can be challenging, and obtaining the correct diagnosis can have immediate therapeutic and prognostic consequences. Here, we describe the key differential diagnostic features of each disease within this clinical spectrum, including representative case examples. Moreover, we discuss the pathogenesis of each disease in order to facilitate the differentiation from typical CSC.

多种眼部疾病可表现为黄斑中的浆液性视网膜下液，因此临床上类似于中央浆液性脉络膜视网膜病变 (CSC)。在这份手稿中，我们将属于鉴别诊断的疾病和病症分为 12 个主要致病亚组：新生血管疾病、卵黄样病变、炎症性疾病、眼部肿瘤、血液系统恶性肿瘤、副肿瘤综合征、遗传疾病、眼部发育异常、药物治疗-相关病症和毒性相关疾病，孔源性视网膜脱离和牵引性视网膜脱离，视网膜血管疾病和其他疾病。此外，我们描述了 2 个与黄斑视网膜下积液相关的新临床图片，即没有视网膜色素上皮的浆液性黄斑病变 (SMARPE) 和非特异性脉络膜病引起的浆液性黄斑病变 (SMACH)。区分这些不同的疾病和 CSC 可能具有挑战性，获得正确的诊断可以立即产生治疗和预后后果。在这里，我们描述了该临床范围内每种疾病的关键鉴别诊断特征，包括代表性病例。此外，我们讨论了每种疾病的发病机制，以促进与典型 CSC 的区分。我们描述了该临床范围内每种疾病的关键鉴别诊断特征，包括代表性病例。此外，我们讨论了每种疾病的发病机制，以促进与典型 CSC 的区分。我们描述了该临床范围内每种疾病的关键鉴别诊断特征，包括代表性病例。此外，我们讨论了每种疾病的发病机制，以促进与典型 CSC 的区分。