Posterior Segment
Peripapillary Pachychoroid Syndrome
Also known as: peripapillary pachychoroid syndrome, PPS, peripapillary fluid, nasal macular fluid, pachychoroid spectrum, peripapillary intraretinal fluid
Filed as: Soon
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Peripapillary pachychoroid syndrome is a pachychoroid spectrum disorder, possibly a subset of central serous chorioretinopathy, in which the choroid is thickest nasally and pockets of fluid collect beside the optic disc, usually extending from its temporal margin into the nasal macula. Choroidal folds and optic disc swelling can accompany it, and peripapillary choroidal neovascularisation can develop. The course is variable and there is no agreed treatment. The optometry role is to recognise the pattern on OCT, keep disc swelling from other causes in mind, and refer to ophthalmology.
Recognition
Symptoms: what patients report
- Blur or distortion when fluid reaches the macula.
- No symptoms when fluid stays beside the disc.
- Often an older adult; both eyes may be involved.
Signs: what the examination shows
- Mottling of the RPE around the optic disc.
- Choroidal folds and optic disc swelling in some eyes.
- OCT: intraretinal and or subretinal fluid next to the disc, typically reaching the nasal macula, sometimes with outer retinal atrophy. The choroid is thick nasally.
- OCT may show a fibrovascular pigment epithelial detachment beside the disc if neovascularisation has developed.
- Fundus autofluorescence: mixed bright and dark signal over the affected area.
What OptoGuide™ covers for peripapillary pachychoroid syndrome
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting