PP104 : Validating the pachychoroid spectrum with multimodal imaging

Dr.Apoorva A G

39 year old male came with DOV, OD since one week. VA- 20/60 , N12 OD & 20/20 N6 OS. Submacular hemorrhage was noted OD. SD- OCT showed submacular hemorrhage,notched PED & characteristic “double layer sign”. Fundus autofluorescence showed hypoautofluorescence corresponding to submacular blood and central hyperautofluorescence corresponding to PED. Pneumatic displacement was done with C3F8. 8 days later, multi modal imaging- SD- OCT, OCTA, FFA and ICG were done.Reduction in submacular hemorrhage.OCTA- abnormal vasculature between RPE and BM denoting branching vascular network, no polyps hence suggesting type 1 PCV. FFA and ICG showed BVN nasal to the PED. Additionally, there were 3 leaks suggestive of CSCR temporal to macula. EDI- OCT showed pachychoroid with SCFT 304µ. Other eye showed RPE changes and pachychoroid. Afilibercept 2 mg was given leading to marked improvement. This case report validates the hypothesis that CSCR and PCV are offshoots from pachychoroid and can coexist.