Peripapillary Pachychoroid Syndrome

Introduction

Choroidal thickening occurs in the peripapillary region, giving the optic disc a crowded appearance.
- Can lead to a loss of disc margin definition, and regions of scattered hypo-AF and hyper-AF

Dead Giveaways

The biggest giveaway is the OCT:

Note pachychoroid, and features of pachychoroid disease spectrum, but adjacent to the ONH

FAF also shows pachychoroidal changes near the disc, as well as a less defined disc edge

diagnostic features

Can have associated FIPED, choriocapillaris compression, FCE, and epiretinal membranes