Purpose: To report a rare case of bilateral pachychoroid spectrum disease presenting asymmetrically as chronic central serous chorioretinopathy (CSCR) in 1 eye and type 3 uveal effusion syndrome in the contralateral eye. Methods: A single case was reviewed. Results: A 47-year-old man presented with a 1-month history of decreased vision in the left eye while being on oral corticosteroids. Best-corrected visual acuity was 20/20 OD and 2/80 OS. Multimodal imaging revealed features of CSCR with an ink-blot leak in the right eye and idiopathic type 3 uveal effusion syndrome with exudative retinal and choroidal detachment in the left eye. The patient was treated with a tapering course of oral corticosteroids, resulting in complete resolution of both conditions. During a 2-year follow-up period, a recurrence of subretinal fluid was observed in the right eye. Conclusions: This unusual case highlights the spectrum of venous overload choroidopathy and emphasizes the overlapping yet distinct clinical features of CSCR and uveal effusion syndrome. Multimodal imaging plays a pivotal role in the diagnosis and management of such unique presentations.
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