Pachychoroid Spectrum Disorders: An Updated Review

Area of Science:

• Ophthalmology
• Retinal Diseases
• Choroidal Disorders

Background:

• The pachychoroid disease spectrum is an evolving classification for several related retinal conditions.
• These conditions share underlying choroidal characteristics and manifest with diverse clinical presentations.

Purpose of the Study:

• To review updated findings on the pachychoroid disease spectrum.
• To discuss pathogenic mechanisms and imaging advancements for these entities.
• To advocate for a unified classification system.

Main Methods:

• Comprehensive literature review of typical and emerging pachychoroid entities.
• Analysis of current research on pathogenic mechanisms.
• Evaluation of recent imaging modalities and findings.

Main Results:

• Detailed overview of central serous chorioretinopathy, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, peripapillary pachychoroid syndrome, and focal choroidal excavation.
• Inclusion of peripapillary pachychoroid neovasculopathy and peripheral exudative hemorrhagic chorioretinopathy as newer entities.
• Discussion of shared and distinct pathogenic pathways and imaging signatures.

Conclusions:

• The pachychoroid spectrum encompasses a growing list of phenotypes with shared underlying pathology.
• Advancements in imaging have improved understanding and diagnosis.
• A standardized classification is crucial for research and clinical practice.