for a routine preemployment eye checkup. He was asymptomatic with no visual complaints. He was otherwise healthy with no systemic illnesses. The patient had no complaints of visual difficulty in dim light. He had never suffered an ocular trauma or seen a solar eclipse unaided. There was no history suggestive of any ocular infection. He denied a history of drug intake. Birth history, as far as he was aware, was negative for prematurity, low birth weight, and major antenatal or postnatal problems. His family history was also unremarkable, with no consanguinity. His vision was 20/32 in the right eye with a small refractive correction of plano with 21.50 D cylinder at 130°. The vision was 20/20, unaided, in the left eye. His near vision was N6 in both eyes with no correction needed. He could identify all the pseudoisochromatic plates of the Ishihara chart easily. He was orthophoric with normal ocular motility. His anterior segment examination and the intraocular pressures were within normal limits.The fundus examination revealed clear vitreous with bilateral symmetrical oblong areas of retinal thinning at the fovea with a central linear train of tiny hypopigmented patches of retinal pigment epithelial atrophy (Figure 1, A and B). These were better seen in the red-free photographs (Figure 1, C and D). The fundus autofluorescence (FAF) images showed punctate FAF at the fovea surrounded by an oval ring of hyperautofluorescence. There was a zone of hypoautofluorescence with indistinct edges surrounding this ring (Figure 1, E and F). The spectral domain optical coherence tomography imaging showed a saucer-shaped excavation with retinal thinning at the fovea bilaterally, in the horizontal axis (Figure 2). The outer nuclear layer was absent and appeared to be replaced with a hyperreflective layer seen to be continuous with the ganglion cell layer. There were one large and a few tiny defects

We report a case of retinitis pigmentosa (RP) coexisting with acute central serous chorioretinopathy (CSCR) with pachychoroid phenotype. A 37-year-old male showed clinical features of RP in both eyes with acute CSCR in the right eye. Fundus fluorescein angiography showed ink blot hyperfluorescence with focal leakage, which was successfully treated with focal laser. Both eyes showed features of pachychoroid. RP and CSCR occurring simultaneously is very rare and there are only a few reports published in literature, but none with pachychoroid features. We report the first case of RP with acute CSR with pachychoroid phenotype and comment on its treatment outcome.

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