Multimodal Imaging in a Case of Bilateral Cuticular Drusen with Pachychoroid Phenotype and Pachychoroid Driven Central Serous Chorioretinopathy

Purpose: To report a case of a 30-year-old male with bilateral cuticular drusen with bilateral pachychoroid phenotype and left eye pachychoroid driven central serous chorioretinopathy (CSC). Methods: Clinical fundus examination and multimodal imaging which included optical coherence tomography (OCT), fundus autofluorescence (FAF) and fundus fluorescein angiography (FFA) was done. Results: A patient presented to us with subretinal fluid at the macula in the left eye. FFA was done and the presence of ink blot pattern leakage confirmed the diagnosis of CSC in left eye, along with multiple, small, round, hyperfluorescent spots, creating a classic “starry-sky” pattern along the vascular arcades characteristic of cuticular drusen in both eyes. On OCT, we noted characteristic features of pachychoroid in both eyes. Conclusion: The role of multimodal imaging in diagnosing a rare case of cuticular drusen with pachychoroid CSC in a young adult is important.