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Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 10/2019

01-10-2019 | Retinal Disorders

Morphological changes of focal choroidal excavation

Authors: Chen Zheng-yu, Shao Lei, Wei Wen-bin

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2019

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Abstract

Purpose

To investigate morphological changes of focal choroidal excavation (FCE).

Methods

The medical records of 18 FCE patients (25 eyes) were retrospectively reviewed. Clinical features as well as images of ocular fundus, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and spectral domain optical coherence tomography (OCT) were analyzed. OCT images were employed as a major criterion to evaluate the changes which occurred during the follow-up.

Result

Of the 18 patients, 9 were male and 9 were female. The mean age was 41 ± 13.5 years. The follow-up period was 38.5 ± 24.7 (7–92) months. Thirteen patients were myopic. FCE appeared from slight pigment irregularity to yellowish white plaque. FFA revealed window defects corresponding to the lesions. Early-phase ICGA images showed hypofluorescence and medium to large choroidal blood vessels. Plaque- or dot-like hyperfluorescence was seen on late-phase images. OCT scans showed that 11 patients had unilateral FCE and 7 patients were bilaterally affected. Twenty-three eyes had a single FCE and the other two eyes had 2 excavations. FCE presented as confirming type in 21 eyes and non-confirming type in 3 eyes. Discontinuity of the interdigitation zone, ellipsoid zone, and retinal pigment epithelium/Bruch’s complex zone was found. The average subfoveal choroidal thickness was 312.06 ± 66.12 μm in FCE eyes. During the follow-up, choroidal neovascularization developed in 4 patients and retinal pigment epithelium discontinuity was aggravated in one eye. No remarkable changes were found in the other eyes on B scan of the OCT images, but the volume of FCE might have changed a little.

Conclusion

FCE, both confirming type and non-confirming type, may keep stable during a long period of time. Choroidal neovascularization may develop at the site of FCE.
Literature
1.
Jampol L, Shankle J, Schroeder R et al (2006) Diagnostic and therapeutic challenges. Retina 26:1072–1076CrossRef
2.
Wakabayashi Y, Nishimura A, Higashide T et al (2010) Unilateral choroidal excavation in the macula detected by spectraldomain optical coherence tomography. Acta Ophthalmol 88:e87–e91CrossRef
3.
Margolis R, Mukkamala SK, Jampol LM et al (2011) The expanded spectrum of focal choroidal excavation. Arch Ophthalmol 129:1320–1325CrossRef
4.
Shinojima A, Kawamura A, Mori R et al (2014) Morphologic features of focal choroidal excavation on spectral domain optical coherence tomography with simultaneous angiography. Retina. 34(7):1407–1414CrossRef
5.
Obata R, Takahashi H, Ueta T et al (2013) Tomographic and angiographic characteristics of eyes with macular focal choroidal excavation. Retina 33:1201–1210CrossRef
6.
Lee CS, Woo SJ, Kim YK et al (2014) Clinical and spectral-domain optical coherence tomography findings in patients with focal choroidal excavation. Ophthalmology. 121(5):1029–1035CrossRef
7.
Pierro L, Casalino G, Introini U et al (2015) Natural course of symptomatic focal choroidal excavation. Ophthalmic Surg Lasers imaging Retina 46(1):125–130CrossRef
8.
Park KA, Oh SY (2015) The absence of focal choroidal excavation in children and adolescents without retinal or choroidal disorders or ocular trauma. Eye (Lond) 29:841–842CrossRef
9.
Xu H, Zeng FX, Shi DP et al (2014) Focal choroidal excavation complicated by choroidal neovascularization. Ophthalmology. 121(1):246–250CrossRef
10.
Lee JH, Lee WK (2014) Choroidal neovascularization associated with focal choroidal excavation. Am J Ophthalmol 157(3):710–718CrossRef
11.
Ellabban AA, Tsujikawa A, Ooto S et al (2013) Focal choroidal excavation in eyes with central serous chorioretinopathy. Am J Ophthalmol 156:673–683CrossRef
12.
Kuroda Y, Tsujikawa A, Ooto S et al (2014) Association of focal choroidal excavation with age-related macular degeneration. Invest Ophthalmol Vis Sci 55:6046–6054CrossRef
13.
Lim FP, Wong CW, Loh BK et al (2016) Prevalence and clinical correlates of focal choroidal excavation in eyes with agerelated macular degeneration, polypoidal choroidal vasculopathy and central serous chorioretinopathy. Br J Ophthalmol 100(7):918–923CrossRef
14.
Suzuki M, Gomi F, Hara C et al (2014) Characteristics of central serous chorioretinopathy complicated by focal choroidal excavation. Retina. 34:1216–1222CrossRef
15.
Chung H, Byeon SH, Freund KB (2017) Focal choroidal excavation and its association with pachychoroid spectrum disorders.: a review of the literature and multimodal imaging findings. Retina. 37(2):199–221CrossRef
16.
Matsubara H, Uchiyama E, Suzuki K et al (2018) A case of focal choroidal excavation development associated with multiple evanescent white dot syndrome. Case Rep Ophthalmol 9(2):388–394CrossRef
17.
Hashimoto Y, Saito W, Noda K et al (2014) Acquired focalchoroidal excavation associated with multiple evanescent whitedot syndrome: observations at onset and a pathogenic hypothesis. BMCOphthalmol 20:135
18.
Ohki T, Sakai T, Tsuneoka H (2015) Focal choroidal excavationassociated with focal retinochoroiditis. Optom Vis Sci 92:e12–e20CrossRef
19.
Kim H, Woo SJ, Kim YK et al (2015) Focal choroidal excavationin multifocal choroiditis and punctate innerchoroidopathy. Ophthalmology 122:1534–1535CrossRef
20.
Nishikawa Y, Fujinami K, Watanabe K et al (2014) Clinical courseof focal choroidal excavation in Vogt-Koyanagi-Harada disease. Clin Ophthalmol 8:2461–2465PubMedPubMedCentral
21.
Karapetyan A, Ouyang P, Tang LS et al (2016) Choroidal thickness in relation to ethnicity measured using enhanced depth imaging optical coherence tomography. Retina. 36(1):82–90CrossRef
Metadata
Title
Morphological changes of focal choroidal excavation
Authors
Chen Zheng-yu
Shao Lei
Wei Wen-bin
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-019-04374-3

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