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CURRENT VIEW OF THE SPECTRUM OF PACHYCHOROID DISEASES. A REVIEW.

A Stepanov

    Ceska a Slovenska Oftalmologie : Casopis Ceske Oftalmologicke Spolecnosti a Slovenske Oftalmologicke Spolecnosti
    |August 11, 2023
    PubMed
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    Pachychoroid diseases are characterized by increased choroidal thickness due to dilated vessels. These conditions, including focal choroidal excavation and peripapillary pachychoroid syndrome, require consideration in differential diagnoses based on imaging.

    Keywords:
    choroidopathy of venous congestionfocal choroidal excavationpachychoroidperipapillary pachychoroid syndromevenae vorticosae

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    Area of Science:

    • Ophthalmology
    • Retinal Diseases
    • Choroidal Disorders

    Background:

    • Pachychoroid, defined as choroidal thickness ≥ 300 μm, involves Haller's layer vessel dilation and thinning of Sattler's and choriocapillaris layers.
    • The pachychoroid spectrum encompasses six clinical entities, including central serous chorioretinopathy and polypoid choroidal vasculopathy.

    Purpose of the Study:

    • To review the current understanding of pachychoroid spectrum diseases.
    • To clarify pathophysiological theories behind pachychoroid formation.
    • To describe clinical findings of focal choroidal excavation and peripapillary pachychoroid syndrome.

    Main Methods:

    • Literary research was conducted on pachychoroid spectrum diseases.
    • Review of current pathophysiological theories, including impaired venous outflow and scleral thickening.
    • Description of clinical symptoms and objective findings for specific pachychoroid entities.

    Main Results:

    • Pachychoroid diseases are hypothesized to have an autosomal dominant inheritance pattern.
    • The spectrum includes pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoid choroidal vasculopathy, focal choroidal excavation, and peripapillary pachychoroid syndrome.
    • Impaired choroidal venous outflow and scleral thickening are key pathophysiological factors.

    Conclusions:

    • Pachychoroid diseases present with characteristic multimodal imaging findings.
    • These conditions should be considered in the differential diagnosis of observed choroidal changes.