ABSTRACT The pachychoroid disease spectrum (PDS) encompasses a range of chorioretinal disorders characterized by increased choroidal thickness, dilated Haller’s layer vessels (pachyvessels), and choroidal hyperpermeability, often associated with retinal pigment epithelium (RPE) alterations. This review synthesizes current evidence on pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), and polypoidal choroidal vasculopathy (PCV), emphasizing their shared pathophysiological mechanisms, multimodal imaging features, and clinical implications. Enhanced depth imaging optical coherence tomography (EDI-OCT) and widefield indocyanine green angiography (ICGA) have […]