The purpose of this study was to identify inflammatory cytokines that are associated with pachychoroid neovasculopathy (PNV). Seventy-five eyes of 75 patients with PNV, 145 eyes of 145 patients with neovascular age-related macular degeneration without pachyvessels, and 150 eyes of 150 normal subjects were examined for the levels of intracameral cytokines. In eyes with PNV, IL-1α, IL-1β, IL-2, IL-4, IL-10, and VEGF were significantly elevated compared to controls. Logistic regression analysis indicated highest association with pachyvessels was observed for IL-4, IL-2, and IL-1α. In eyes with PNV, IL-4, TNFα, IL-17, IL-2, IL-12, IL-15, IL-5, IL-13, IL-1α, and IL-1β significantly increased choroidal thickness. Highest correlation with choroidal thickness was observed for IL-4. In PNV eyes with polypoidal lesions, the level of IL-4, IL-17, and TNFβ significantly correlated with the number of polypoidal lesions. We determined how the different disease characteristics of PNV were associated with the elevated cytokines. Of all these cytokines, IL-4 contributed significantly to the thickening of the choroidal vessels and to the formation of polypoidal lesions. We conclude that IL-4 is most likely involved in the establishing the clinical characteristics of PNV and polypoidal vascular remodeling. This may help to establish future therapeutic strategy for PNV.