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.
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Funding
This study is funded by Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20150201), National Natural Science Foundation of China (81570891, 81272981), Beijing Natural Science Foundation (7151003), Advanced Health Care Professionals Development Project of Beijing Municipal Health Bureau (2014-2-003), and Study on individual diagnosis and therapy strategy for malignant uveal melanoma (2016-1-2051).
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All procedures performed in this study were in accordance with the ethical standards of the Beijing Tongren Hospital research committee and with the 1964 Helsinki declaration and its later amendments.
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Synopsis: Focal choroidal excavation may keep stable after an utmost 92-month follow-up or develop choroidal neovascularization within 7 months. All excavations revealed interdigitation zone discontinuity. The confirming type was more often seen the than non-confirming type.
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Zheng-yu, C., Lei, S. & Wen-bin, W. Morphological changes of focal choroidal excavation. Graefes Arch Clin Exp Ophthalmol 257, 2111–2117 (2019). https://doi.org/10.1007/s00417-019-04374-3
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DOI: https://doi.org/10.1007/s00417-019-04374-3