Morphological features of focal choroidal excavation and its association with macular pathology in Asian Indian eyes

Abstract

Purpose: To study the characteristics of focal choroidal excavation (FCE) in Indian eyes based on spectral-domain optical coherence tomography (SD-OCT) findings and their association with macular pathologies. Methods: Retrospective study of 26 patients diagnosed with FCE. All patients‘ clinical and imaging data were reviewed. Results: There were eight females and 18 males aged between 24 and 85 years. FCE was noted in 31 eyes of 26 patients – unilateral in 21 and bilateral in 5. The conforming type was noted in 13 and nonconforming in 19 eyes. The location was extrafoveal in 16 and subfoveal in 15 eyes. The morphology was bowl-shaped in 24, cone-shaped in six eyes, and mixed type in one eye. Associated pathologies were central serous chorioretinopathy in nine eyes, choroidal neovascular membrane in seven eyes, Stargardt‘s disease in three eyes, Best disease in four eyes, other retinal dystrophies in two eyes, polypoidal choroidal vasculopathy and moderate non-proliferative diabetic retinopathy, each in one eye. The mean FCE width was 1667.2 ± 817.7 μ, mean depth was 95.7 ± 46.4 μ, and the mean choroidal thickness under the FCE was 234.8 ± 85.9 μ. No abnormal choroidal tissue was found under any FCE. Conclusion: FCE is a relatively common entity and frequently associated with macular pathologies. The presence of an FCE did not alter the course or management of these conditions.

Unilateral Multifocal Focal Choroidal Excavation

“…It is a relatively common entity and frequently associated with macular pathologies such as central serous chorioretinopathy (CSCR), choroidal neovascularization (CNV), and polypoidal choroidal vasculopathy (PCV). However, there was no statistically significant correlation between the morphological type of FCE and macular pathology [1].…”

“…Focal choroidal excavation (FCE) is defined as an area of choroidal excavation without evidence of a posterior staphyloma or scleral ectasia, detected on spectral-domain optical coherence tomography (SD-OCT) [1]. First described by Jampol in 2006, focal choroidal excavation is an idiopathic choroidal excavation either in the macula or the perifoveal retina [2].…”

Splitting of retinal pigment epithelium and Bruch's membrane due to a focal choroidal excavation

“…Recently, Priya et al . [ 1 ] described a case series on FCE in Asian Indian eyes, enumerating their clinical features and associations. FCE can be seen with normal visual acuity and is mostly unilateral.…”

“…The visual acuity may be normal and FCE can be seen without any preexisting pathologies. [ 1 ] The exact pathogenesis behind its formation is not clear. It is generally thought to be as a result of focal inflammation in the choroid leading to fibrosis and focal contraction.…”