Two Cases of Focal Choroidal Excavation Detected by Spectral-Domain Optical Coherence Tomography

Abstract

Purpose: To report the clinical findings of 2 patients with focal choroidal excavation in the macula detected by spectral-domain optical coherence tomography (SD-OCT). Methods: Three eyes of 2 patients with a focal macular choroidal excavation detected by SD-OCT were studied. The eyes were examined by fundus autofluorescence (FAF), fluorescein angiography, fundus-related microperimetry, and multifocal electroretinography (mfERG). Results: In spite of a complaint of metamorphopsia, the visual acuity was normal in 2 eyes. SD-OCT demonstrated a choroidal excavation in the macula but the foveal contour was normal in 3 eyes. The excavation involved the outer retinal layers up to the external limiting membrane in all eyes, and a type 2 secondary choroidal neovascularization (CNV) developed in 1 of the 3 eyes. There were areas of hypoautofluorescence in the FAF images, and areas of decreased retinal sensitivity determined by microperimetry. These areas corresponded to the choroidal excavation in all eyes. The P1 amplitudes of the mfERGs were decreased in the fovea of 1 eye without a CNV. Conclusions: The choroidal excavation remained stable for 3 years in 2 eyes, a secondary CNV developed in 1 eye during the course of the disease. More cases and longer follow-up periods will be necessary to determine the etiology, clinical course, and visual prognosis of eyes with a choroidal excavation.

Tomographic and Angiographic Characteristics of Eyes With Macular Focal Choroidal Excavation

“…Although Humphrey Visual Field Analysis 10-2 did not show any sensitivity decline, lack of microperimetry, or multifocal electroretinogram, testing fails to detect reduced sensitivity in a very small area or reduced electrophysiologic function. 15 However, we believe that the present case series is the largest study that included detailed clinical examinations to date.…”

Evaluation of focal choroidal excavation in the macula using swept-source optical coherence tomography

“…Most were myopic with mean myopia of À 3.5D, which is similar to two previous reports. 3,4 Focal choroidal excavation has been reported to be associated with CSC, ERM, and subretinal neovascularization previously [3][4][5] and more recently CNV 6 and PCV. 7 In our current study, we also found an association with all the above conditions as well as dry AMD.…”

Association of Focal Choroidal Excavation With Age-Related Macular Degeneration

“…Margolis et al 4 and Katome et al 6 reported that FCE is common in eyes with a thicker choroid. Ellabban et al 25 reported that the choroidal thickness in CSC eyes with FCE was significantly thicker than that in normal eyes but thinner than that in CSC eyes without FCE.…”

“…Subsequent studies using spectral-domain OCT have elucidated the clinical and morphological characteristics of FCE. [2][3][4][5][6][7][8][9][10][11][12] Initially, FCE was considered a stable choroidal abnormality and an incidental finding in patients with metamorphopsia or blurred vision. 10 Recently, it has been suggested that FCE may form the basis of choroidal neovascular diseases.…”