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Yoshimasa Kuroda, Akitaka Tsujikawa, Sotaro Ooto, Kenji Yamashiro, Akio Oishi, Hideo Nakanishi, Kyoko Kumagai, Masayuki Hata, Shigeta Arichika, Abdallah A. Ellabban, Nagahisa Yoshimura; Association of Focal Choroidal Excavation With Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(9):6046-6054. doi: https://doi.org/10.1167/iovs.14-14723.
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To study the prevalence, tomographic features, and clinical characteristics of focal choroidal excavation (FCE) in eyes with exudative age-related macular degeneration (AMD).
We examined 243 consecutive eyes with exudative AMD with a prototype swept-source optical coherence tomography (OCT) system. Three-dimensional images of the macular area, covering 6 × 6 mm2, were reconstructed by segmentation of the outer surface of the retinal pigment epithelium.
Three-dimensional swept-source OCT revealed 15 excavations in 12 eyes (4.9%); 10 had a single excavation and 2 had multiple excavations (2 and 3 excavations, respectively). In multiaveraged scans, unusual choroidal tissue was found beneath 5 excavations, bridging the excavation with the outer choroidal boundary. Additionally, the suprachoroidal space was observed beneath 7 excavations—the outer choroidal boundary appeared to be pulled inward by this bridging tissue. In 9 excavations, color fundus photographs showed pigmentary disturbance. Fourteen excavations (93.3%) were located within or adjacent to the choroidal neovascularization area. Compared with eyes without FCE, in eyes with FCE, the mean age was significantly higher (P = 0.040) and mean visual acuity was significantly better (P = 0.014). In addition, polypoidal lesions were observed in 8 of 12 eyes with FCE, but they appeared to have a limited effect on either the rate of FCE (P = 0.44) or the clinical characteristics of the eyes.
While FCE may be partially related to the choroidal neovascularization associated with exudative AMD, other factors may also influence this association.
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