Turkish Abstract Abstract Free Full Text English Similar Articles Mail to Author

¹Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
²Ayaş Şehit Mehmet Çifci State Hospital, Department of Ophthalmology, Ankara, Turkey DOI : 10.37845/ret.vit.2026.35.13 Pachychoroid spectrum disease (PSD) represents a group of chorioretinal disorders characterized by increased choroidal thickness, dilated outer choroidal vessels (pachyvessels), attenuation of the inner choroid, and retinal pigment epithelium (alterations. Over the past decade, the concept of pachychoroid has evolved from a simple “thick choroid” phenotype into a complex disorder involving choroidal venous congestion, vascular remodeling, and choriocapillaris ischemia. The spectrum includes uncomplicated pachychoroid, pachychoroid pigment epitheliopathy, central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy, and several recently described entities. Recent advances in multimodal imaging, particularly optical coherence tomography angiography (OCTA), widefield indocyanine green angiography, and enhanced depth imaging optical coherence tomography, have substantially improved our understanding of the structural and vascular alterations underlying these diseases. OCTA has emerged as a highly sensitive modality for detecting type 1 macular neovascularization in PSD and has significantly influenced differential diagnosis and treatment strategies. Furthermore, photodynamic therapy, especially reduced-setting protocols, has regained importance owing to its choroidal remodeling effects and favorable outcomes in CSC and PNV. This review summarizes the current concepts regarding pachychoroid disease, with a particular focus on pathophysiology, multimodal imaging findings, differential diagnosis, and therapeutic implications. Keywords : imaging; optical coherence tomography angiography; pachychoroid spectrum disease; photodynamic therapy; vortex anastomoses