Central serous chorioretinopathy complicated by massive bilateral subretinal haemorrhage

Editor,—We read with interest the report by Lipet al,1 describing a 43 year old Asian man with central serous chorioretinopathy (CSCR) complicated by massive bilateral subretinal haemorrhage. The authors attributed the massive haemorrhage to CSCR itself. As the authors have pointed out, massive subretinal macular haemorrhage could be due to several causes, including idiopathic polypoidal choroidal vasculopathy (IPCV). In their article, there is a colour fundus photograph of the left eye (Fig 3A) showing a small red nodule in the centre of fovea with surrounding subretinal hemorrhage. The lesion corresponds to the hyperfluorescent spot in the fluorescein angiogram (FA) and indocyanine green angiogram (ICGA) in the same figure (Fig 3B, C). These clinical pictures are still compatible with the diagnosis of IPCV, although the presence of massive subretinal haemorrhage precludes the visualisation of other classic features of IPCV. Recently, we have had the opportunity of examining a similar patient presented with massive subretinal haemorrhage in one eye, with a history of CSCR documented by FA. ICG of the other eye showed the presence of classic signs of IPCV including dilated choroidal vessels with terminal polyps.2 As CSCR and IPCV are both choroidal vascular diseases, their presence in the same eye or same patient is possible.