4.4 Article

MORPHOLOGIC FEATURES OF FOCAL CHOROIDAL EXCAVATION ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY WITH SIMULTANEOUS ANGIOGRAPHY

Journal

RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 34, Issue 7, Pages 1407-1414

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000000108

Keywords

age-related macular degeneration; central serous chorioretinopathy; choroidal neovascularization; fluorescein angiography; focal choroidal excavation; indocyanine angiography; polypoidal choroidal vasculopathy; spectral domain optical coherence tomography

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Purpose: To reveal clinically relevant morphologic findings in patients with focal choroidal excavation (FCE) using enhanced depth imaging optical coherence tomography. Methods: Thirty-one FCE lesions in 29 eyes of 26 patients (21 men, 23 eyes; 5 women, 6 eyes) were studies. In all 26 patients, color fundus photographs were obtained, and fluorescein angiography and indocyanine green angiography with simultaneous enhanced depth imaging optical coherence tomography were performed. Twenty-five eyes also underwent angiographic video recording. Results: Focal choroidal excavation was detected in eyes with typical age-related macular degeneration, central serous chorioretinopathy, polypoidal choroidal vasculopathy, and idiopathic choroidal neovascularization, whereas in 8 eyes, FCE was considered to be idiopathic. Morphologically, FCE lesions were classified into 3 types: cone-shaped, bowl-shaped, and mixed. The cone-shaped type was detected in 17 lesions, bowl-shaped in 8, and mixed in 6, on optical coherence tomography findings. All bowl-shaped and mixed types had retinal pigment epithelial irregularities within the FCE lesion. The cone-shaped type was not observed in eyes with typical age-related macular degeneration. Conclusions: Morphologically, FCE lesions were classified into cone-shaped, bowl-shaped, and mixed types, based on optical coherence tomography findings. Focal choroidal excavation formation may be associated in part with chorioretinal diseases such as age-related macular degeneration and central serous chorioretinopathy, whereas some eyes are considered to have idiopathic FCE.

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