Shrinkage or compression of the scleral tissue leads to folding of the attached choroid/Bruch's membrane/retinal pigment epithelium (RPE) complex. Bilateral folds are usually the result of age-related scleral shrinkage in hyperopic females (as in this case). The condition is benign.

Unilateral folds are more ominous and can be the result of orbital tumors, hypotony, choroidal neovascular membranes (CNVMs), or posterior scleritis.

	Alternating light and dark bands are seen. They show up clearly on IVFA as light and dark streaks. Need to differentiate from retinal folds (orientation, IVFA, size, underlying etiology).
	Choroidal . . . Usually roughly horizontal Usually posterior pole Light and dark streaks Visible on IVFA Retinal . . . Often stellate alignment Can be anywhere Similar but finer Visible on IVFA only if vascular traction

OCT of Epiretinal Membrane (ERM)	ERM with Neurosensory Retinal Detachment (RD)	Vitreo-Macular Traction Syndrome (VMTS)

Choroidal Folds

Patton's folds are choroidal folds located concentrically around the optic nerve heads in papilledema.