Karacorlu M, et al. - Authors gauged the conversion of pachychoroid pigment epitheliopathy (PPE) lesions and the development of other pachychoroid spectrum diseases in patients with PPE during follow-up. The eye of patients who had a diagnosis of PPE and were followed up for at least 3 years were retrospectively reviewed. A retinal pigment epithelium (RPE) elevation with microbreak appearance (REwM) of RPE is the smallest PPE lesion that can be detected. For pachychoroid spectrum disease, it may be the precursor lesion. Central serous chorioretinopathy (CSC) was seen to develop in the eyes with PPE (17.4%), and none developed pachychoroid neovasculopathy or polypoidal choroidal vasculopathy.