Subretinal fluid due to leakage under the retina is most characteristic of which condition?

• A. Central Serous Retinopathy
• B. Retinal Detachment
• C. Macular Hole
• D. Diabetic Macular Edema

Answer: (A)

Subretinal fluid arises when fluid leaks through a compromised RPE into the space beneath the neurosensory retina, producing a serous detachment. This pattern is classic for central serous retinopathy, where focal choroidal leakage at the RPE leads to a serous detachment visible on OCT as a smooth, elevated area under the retina. The other conditions involve different mechanisms or morphologies: a full-thickness retinal detachment shows a broad separation of the entire retina from the RPE due to a detachment caused by a tear or traction, not just leakage under the retina; a macular hole creates a full-thickness foveal defect with characteristic tissue loss and potential foveal detachment but not a serous subretinal fluid accumulation; diabetic macular edema features intraretinal fluid in cystic spaces from capillary leakage, with subretinal fluid being less typical and not the defining feature. Therefore, subretinal fluid from leakage under the retina most strongly points to central serous retinopathy.