Unilateral choroidal excavation in the macula detected by spectral‐domain optical coherence tomography

Abstract

ABSTRACT.Purpose: To report clinical findings of three patients with unilateral peculiar choroidal excavation in the macula detected by spectral-domain (SD) optical coherence tomography (OCT). Methods: Three cases with unilateral choroidal excavation in the macula detected by SD OCT. Fluorescein angiography (FA), indocyanine green angiography (IA), ultrasonography, visual field tests and multifocal electroretinography (mfERG) were performed. Results: Although all three patients complained of metamorphopsia, visual acuity and central visual field were normal in the affected eyes. SD OCT demonstrated choroidal excavation in the macula despite a normal foveal contour along the inner retinal surface. The excavation involved the outer retinal layers up to the external limiting membrane in cases 1 and 2, while only the retinal pigment epithelium was involved in case 3. The excavation corresponded to foveal pigment mottling in cases 1 and 2 and to a parafoveal yellowish fusiform lesion in case 3. The lesions appeared hypoautofluorescent and unremarkable in FA except for circumferential hyperfluorescence in case 3 and hypofluorescent in IA. B-scan ultrasonography was unremarkable. MfERG in cases 1 and 2 was normal. Conclusions: SD OCT demonstrated two types of choroidal excavation in the macula. More case accumulation and a longer follow-up will elucidate the pathogenesis and prognosis of the lesions.

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

“…Previous reports have reported non-specific pigmentary changes and yellow spots correlating to the area of FCE on fundal examination, but none reported the direct visualization of the excavation clinically. [1][2][3]5,8 Of our three patients with no co-existing pathology at the site of FCE, RPE mottling at the area of excavation was seen in two eyes, whereas no abnormality was detected in the remaining eye. In these eyes, observation over time did not show any worsening of symptoms or clinical appearance on fundal examination.…”

Focal choroidal excavation in patients with central serous chorioretinopathy

“…Previous studies have described two patterns of FCE: the conforming type in which the outer retinal layers conform to retinal pigment epithelial (RPE) alterations within the excavation; and the nonconforming type, in which there is separation between the outer retina and the RPE within the excavation. 2,3 Since the first description of FCE, FCE has been found to be associated with a number of conditions including central serious chorioretinopathy (CSC), polypoidal choroidal vasculopathy (PCV), choroidal neovascularization (CNV), and age-related macular degeneration (AMD). [2][3][4][5][6] In particular, there appeared to be a higher prevalence of FCE in patients with CSC.…”

“…2,3 Since the first description of FCE, FCE has been found to be associated with a number of conditions including central serious chorioretinopathy (CSC), polypoidal choroidal vasculopathy (PCV), choroidal neovascularization (CNV), and age-related macular degeneration (AMD). [2][3][4][5][6] In particular, there appeared to be a higher prevalence of FCE in patients with CSC. [3][4][5][6][7] The aim of this study is to evaluate the prevalence, clinical features and outcome of FCE in patients presenting with CSC.…”

The Frequency Of Focal Choroidal Excavation Detected By Optical Coherence Tomography

“…The FCE was defined as the presence of a focal intrachoroidal concavity or downward deflection of the Bruch's membrane-retinal pigment epithelium (RPE)-choriocapillaris complex line in the macula detected in SD-OCT scans analyzed by a single retina specialist (BT), without the evidence of a posterior staphyloma or scleral ectasia [2][3][4][5] . The FCEs were categorized into two types described by Wakabayashi et al as ''nonconforming and conforming'' depending on the separation between the neurosensory retina and RPE, and three types described by Shinojima et al as ''cone-shaped type, bowlshaped type and the mixed type'' [24,25] .…”