Abstract
Purpose
To evaluate imaging findings of patients with focal choroidal excavation (FCE) in the macula using swept-source optical coherence tomography (SS-OCT) and correlate it clinically.
Methods
Prospective observational case series. Eleven consecutive patients (12 eyes) with FCE were described. Data on demographics and clinical presentation were collected and imaging findings (including color photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and SS-OCT) were analyzed.
Results
The primary diagnosis was epiretinal membrane (two eyes), choroidal neovascularization (one eye), polypoidal choroidal vasculopathy (three eyes), central serous chorioretinopathy (one eye), and dry age-related macular degeneration (two eyes). Eleven out of 12 of the lesions were conforming. One presented with a non-conforming lesion that progressed to a conforming lesion. One eye had multiFCE and two had two overlapping choroidal excavations. Using the SS-OCT, we found the choroid to be thinned out at the area of FCE but sclera remained normal. The choroidal tissue beneath the FCE was abnormal, with high internal reflectivity and poor visualization of choroidal vessels. There was loss of contour of the outer choroidal boundary that appeared to be pulled inward by this abnormal choroidal tissue. A suprachoroidal space was noted beneath this choroidal tissue and the choroidal–scleral interface was smooth. Repeat SS-OCT 6 months after presentation showed the area of excavation to be stable in size.
Conclusion
FCE can be associated with epiretinal membrane, central serous chorioretinopathy, and age-related macular degeneration. The choroid was thinned out in the area of FCE.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Jampol LM, Shankle J, Schroeder R, Tornambe P, Spaide RF, Hee MR . Diagnostic and therapeutic challenges. Retina 2006; 26: 1072–1076.
Wakabayashi Y, Nishimura A, Higashide T, Ijiri S, Sugiyama K . Unilateral choroidal excavation in the macula detected by spectral-domain optical coherence tomography. Acta Ophthalmol 2010; 88: 87–91.
Margolis R, Mukkamala SK, Jampol LM, Spaide RF, Ober MD, Sorenson JA et al. The expanded spectrum of focal choroidal excavation. Arch Ophthalmol 2011; 129: 1320–1325.
Obata R, Takahashi H, Ueta T, Yuda K, Kure K, Yanagi Y . Tomographic and Angiographic characterisitcs of eyes with macular focal choroidal excavation. Retina 2013; 33: 1201–1210.
Ellabban AA, Tsujikawa A, Matsumoto A, Yamashiro K, Oishi A, Ooto S et al. Three-dimensional tomographic features of dome-shaped macula by swept-source optical coherence tomography. Am J Ophthalmol 2013; 155: 320–328.
Katome T, Mitamura Y, Hotta F, Niki M, Naito T . Two cases of focal choroidal excavation setected by spectral-domain optical coherence tomography. Case Rep Ophthalmol 2012; 3: 96–103.
Kobayashi W, Abe T, Tamai H, Nakazawa T . Choroidal excavation with polypoidal choroidal vasculopathy: a case report. Clin Ophthalmol 2012; 6: 1373–1376.
Abe S, Yamamoto T, Kirii E, Yamashita H . Cup shaped choroidal excavation detected by optical coherence tomography: a case report. Retin Cases Brief Rep 2010; 4: 373–376.
Ohno-Matsui Kyoko, Akiba Masahiro, Moriyama Muka, Ishibashi Tatsuro, Hirakata Akito, Tokoro Takashi . Intrachoroidal cavitation in macular area of eyes with pathological myopia. Am J Ophthal 2012; 154: 382–393.
Margolis R, Spaide RF . A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol 2009; 147: 811–815.
Gilbert C, Hiscott P, Unger W, Grierson I, McLeod D . Inflammation and the formation of epiretinal membrane. Eye 1988; 2: 150–156.
Acknowledgements
We would like to thank all the staff and allied health in the Singapore National Eye Centre for their support in this case series.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Additional information
This study has been presented at the Society of European Ophthalmology Meeting in Copenhagen on 8 June 2013.
Rights and permissions
About this article
Cite this article
Lim, F., Loh, B., Cheung, C. et al. Evaluation of focal choroidal excavation in the macula using swept-source optical coherence tomography. Eye 28, 1088–1094 (2014). https://doi.org/10.1038/eye.2014.78
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2014.78
This article is cited by
-
Visual functions and multimodal imaging of patients with idiopathic focal choroidal excavation
Scientific Reports (2024)
-
Pachychoroid disease
Eye (2019)
-
Recurrent focal choroidal excavation following multiple evanescent white dot syndrome (MEWDS) associated with acute idiopathic blind spot enlargement
International Ophthalmology (2018)
-
Focal choroidal excavation—morphological features and clinical correlation
Eye (2017)
-
Focal choroidal excavation in patients with central serous chorioretinopathy
Eye (2015)
