International Ophthalmology

, Volume 39, Issue 11, pp 2667–2673 | Cite as

Chorioretinal folds: a proposed diagnostic algorithm

  • Alessandro BagnisEmail author
  • Carlo Alberto Cutolo
  • Guido Corallo
  • Donatella Musetti
  • Massimo Nicolò
  • Carlo Enrico Traverso



To create a diagnostic algorithm for the management of chorioretinal folds.


We reviewed the existing literature about chorioretinal folds focusing our attention on three specific conditions and created a diagnostic algorithm in order to otpimize the choice and the number of investigations.


Chorioretinal folds are visible striations of the fundus usually arranged in parallel lines and disposed horizontally. They may be either unilateral or bilateral, symptomatic or asymptomatic and are often associated with different possible ocular and extra ocular pathologies, including systemic diseases like autoimmune disorders and intracranial hypertension. They are named idiopathic when no apparent cause for their development is detectable. However, with improved diagnostic testing, the patients with idiopathic choroidal folds are likely to represent only a smaller portion of the total.


Since choroidal folds be the sole sign of an underlying disease possibly requiring a multidisciplinary approach, an appropriate work-up varying according to the specific clinical features of each case is needed to define the etiology and the treatment. A diagnosting algorithm may be useful in order to optimize the diagnostic approach and management.


Chorioretinal folds Ocular diseases Systemic diseases 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Agarwal A (2011) Gass’ atlas of macular diseases, 5th edn. Elsevier Health Sciences, AmsterdamGoogle Scholar
  2. 2.
    Leahey AB, Brucker AJ, Wyszynski RE, Shaman P (1993) Chorioretinal folds. A comparison of unilateral and bilateral cases. Arch Ophthalmol Chic Ill 111:357–359CrossRefGoogle Scholar
  3. 3.
    Friberg TR (1989) The etiology of choroidal folds. A biomechanical explanation. Graefes Arch Clin Exp Ophthalmol 227:459–464CrossRefGoogle Scholar
  4. 4.
    Nettleship E (1884) Peculiar lines in the choroid in a case papillitic atrophy. Ophthalmol Soc U K 4:167–168Google Scholar
  5. 5.
    Cangemi FE, Trempe CL, Walsh JB (1978) Choroidal folds. Am J Ophthalmol 86:380–387. CrossRefPubMedGoogle Scholar
  6. 6.
    Cohen SM, Gass JDM (1994) Bilateral radial chorioretinal folds. Int Ophthalmol 18:243–245. CrossRefPubMedGoogle Scholar
  7. 7.
    Denniston A, Murray P (2009) Oxford handbook of ophthalmology, 2nd edn. Oxford University Press, Oxford, New YorkGoogle Scholar
  8. 8.
    Md PKK, Md NJF, Md RPII (2014) The Massachusetts eye and ear infirmary illustrated manual of ophthalmology, 4th edn. Saunders, PhiladelphiaGoogle Scholar
  9. 9.
    Griebel SR, Kosmorsky GS (2000) Choroidal folds associated with increased intracranial pressure. Am J Ophthalmol 129:513–516CrossRefGoogle Scholar
  10. 10.
    Lavinsky J, Lavinsky D, Lavinsky F, Frutuoso A (2007) Acquired choroidal folds: a sign of idiopathic intracranial hypertension. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol 245:883–888. CrossRefGoogle Scholar
  11. 11.
    Kim KY, Kwak H-W, Kim M, Yu S-Y (2013) Traumatic chorioretinal folds treated with intra-vitreal triamcinolone injection. Indian J Ophthalmol 61:179–182. CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Söylev MF, Saatci O, Saatci I et al (1996) Choroidal folds associated with a sellar mass. Int Ophthalmol 20:259–261. CrossRefPubMedGoogle Scholar
  13. 13.
    Ernst BB, Lowder CY, Meisler DM, Gutman FA (1991) Posterior segment manifestations of inflammatory bowel disease. Ophthalmology 98:1272–1280. CrossRefPubMedGoogle Scholar
  14. 14.
    Grinager HS, Krason DA, Olsen TW (2012) Lyme disease: resolution of a serous retinal detachment and chorioretinal folds after antibiotic therapy. Retin Cases Brief Rep 6:232–234. CrossRefPubMedGoogle Scholar
  15. 15.
    Krist D, Wenkel H (2002) Posterior scleritis associated with Borrelia burgdorferi (Lyme disease) infection. Ophthalmology 109:143–145CrossRefGoogle Scholar
  16. 16.
    Leventer DB, Linberg JV (1960) Ellis B (2001) Frontoethmoidal mucoceles causing bilateral chorioretinal folds. Arch Ophthalmol Chic Ill 119:922–923CrossRefGoogle Scholar
  17. 17.
    Taban M, Kosmorsky GS, Singh AD, Sears JE (2007) Choroidal folds secondary to parasellar meningioma. Eye Lond Engl 21:147–150. CrossRefGoogle Scholar
  18. 18.
    Kalina RE, Mills RP (1980) Acquired hyperopia with choroidal folds. Ophthalmology 87:44–50CrossRefGoogle Scholar
  19. 19.
    Gass’ Atlas of Macular Diseases, 5th edn. Accessed 14 Nov 2017
  20. 20.
    Murdoch D, Merriman M (2002) Acquired hyperopia with choroidal folds. Clin Experiment Ophthalmol 30:292–294CrossRefGoogle Scholar
  21. 21.
    Olsen TW, Palejwala NV, Lee LB et al (2014) Chorioretinal folds: associated disorders and a related maculopathy. Am J Ophthalmol 157:1038–1047. CrossRefPubMedGoogle Scholar
  22. 22.
    Fannin LA, Schiffman JC, Budenz DL (2003) Risk factors for hypotony maculopathy. Ophthalmology 110:1185–1191. CrossRefPubMedGoogle Scholar
  23. 23.
    Schubert HD (1996) Postsurgical hypotony: relationship to fistulization, inflammation, chorioretinal lesions, and the vitreous. Surv Ophthalmol 41:97–125CrossRefGoogle Scholar
  24. 24.
    Thomas M, Vajaranant TS, Aref AA (2015) Hypotony maculopathy: clinical presentation and therapeutic methods. Ophthalmol Ther 4:79–88. CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Rivara A, Zingirian M (1968) Volume du bulbe et rigidité sclérale. Ophthalmologica 156:394–398. CrossRefPubMedGoogle Scholar
  26. 26.
    Benson WE (1988) Posterior scleritis. Surv Ophthalmol 32:297–316CrossRefGoogle Scholar
  27. 27.
    Cavallini GM, Volante V, Bigliardi MC et al (2014) Bilateral posterior scleritis as a presenting manifestation of giant cell arteritis: a case report. Can J Ophthalmol J Can Ophtalmol 49:e141–e143. CrossRefGoogle Scholar
  28. 28.
    McCluskey PJ, Watson PG, Lightman S et al (1999) Posterior scleritis: clinical features, systemic associations, and outcome in a large series of patients. Ophthalmology 106:2380–2386. CrossRefPubMedGoogle Scholar
  29. 29.
    Onal S, Tugal-Tutkun I, Neri P, Herbort CP (2014) Optical coherence tomography imaging in uveitis. Int Ophthalmol 34:401–435. CrossRefPubMedGoogle Scholar
  30. 30.
    Haruyama M (2001) Indocyanine green angiographic findings of chorioretinal folds. Jpn J Ophthalmol 45:293–300. CrossRefPubMedGoogle Scholar
  31. 31.
    Del Turco C, Rabiolo A, Carnevali A et al (2017) Optical coherence tomography angiography features of chorioretinal folds: a case series. Eur J Ophthalmol 27:35–38. CrossRefGoogle Scholar
  32. 32.
    Musetti D, Nicolò M, Bagnis A, Traverso CE (2014) Chorioretinal folds: associated disorders and a related maculopathy. Am J Ophthalmol 158:409. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Alessandro Bagnis
    • 1
    • 2
    Email author
  • Carlo Alberto Cutolo
    • 1
    • 2
  • Guido Corallo
    • 1
  • Donatella Musetti
    • 1
    • 2
  • Massimo Nicolò
    • 1
    • 2
  • Carlo Enrico Traverso
    • 1
    • 2
  1. 1.Clinica Oculistica, DiNOGMIUniversità degli Studi di GenovaGenoaItaly
  2. 2.IRCCS Ospedale Policlinico San MartinoGenoaItaly

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