A 15-year-old boy was referred for possible retinitis pigmentosa. He had no visual complaints, and his visual acuity was 20/20 OD and 20/30 OS. A fundus examination and photographs (Figure) showed asymmetric perivenous bone-spicule pigment, especially in the peripapillary and perivenous areas, corresponding to outer retinal layer atrophy on optical coherence tomography (not shown), but normal optic nerves and vessel caliber. Automated visual field test results demonstrated constriction more prominent in the left eye. These findings are consistent with pigmented paravenous retinochoroidal atrophy.