Crocodile Skin Retinal Appearance: Miliary Distribution of Bilateral Idiopathic Multifocal Retinal Pigment Epithelial...

This report presents cases of an unusual appearance of bilateral idiopathic multifocal retinal pigment epithelial detachments (PEDs) in three patients, using multimodal imaging. Three patients with multiple PEDs, initially diagnosed as drusen, were referred for evaluation. They underwent comprehensive ophthalmic examination and multimodal imaging. All patients had a best-corrected visual acuity of 6/6 in both eyes. Fundoscopy revealed multiple idiopathic PEDs in a miliary distribution, resembling crocodile skin. Systemic workup excluded associated diseases, though one patient was pregnant. The pathogenesis and progression are poorly understood, but prognosis is favorable without intervention unless complications arise. [Ophthalmic Surg Lasers Imaging Retina 2025;56:108-112.].