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30, P = 0.003), and PHS with pachydrusen (φ 0.20, P = 0.04. Over a mean follow-up of 74.8months, new drusen co-localizing to PHS were noted in 22 (21.0%) eyes (φ 0.54, P 0.001). We observed a trend of pachydrusen appearing in conjunction with PHS in PCV or PNV. Frequent localization of new drusen to these choroidal lesions was observed over long-term follow-up. PHS may be a form of late-staining "forme fruste" drusen, possibly associated with micro-ischemic changes to the choriocapillaris. We observed a trend of pachydrusen appear