Serous Maculopathy due to Aspecific Choroidopathy (SMACH): a case report with differential diagnosis based on multimodal imaging analysis.
Xuan Ren, Xinxin Yu, Shuai Huang et al.
✦ AI-curated · Sources linked
Case in brief
A 76-year-old Asian female presented with blurred vision in her left eye for six months. Examination revealed multiple yellowish-white subretinal lesions. Multimodal imaging, including OCT and angiography, showed hyperreflective exudates, choroidal thickening, and outer retinal damage. Systemic evaluations ruled out other diseases, leading to a diagnosis of Serous Maculopathy due to Aspecific Choroidopathy (SMACH).
Diagnostic / clinical pearl
Multimodal imaging is essential for diagnosing SMACH, as it reveals characteristic features that can differentiate it from similar conditions like central serous chorioretinopathy and age-related macular degeneration.
Why it matters
Accurate diagnosis of SMACH is critical to avoid mismanagement, particularly in elderly patients where its clinical presentation overlaps with more common chorioretinal diseases.