Abstract
Purpose: :
to report the clinical and spectral-domain optical coherence tomography (SD-OCT) findings in patients with focal choroidal excavation (FCE).
Methods: :
Seven consecutive patients (eight eyes) diagnosed as having FCE were enrolled. Patients were evaluated with best-corrected visual acuity (BCVA) with ETDRS charts, comprehensive ophthalmic examination, and SD-OCT. Two types of SD-OCT were used: Spectralis HRA + OCT (Heidelberg Engineering, Heidelberg, Germany) and Cirrus HD-OCT, (Carl Zeiss Meditec Inc., Dublin, CA, USA). FCE was defined conforming when no separation between the outer retinal layers and the retinal pigment epithelium was shown. FCE was defined non-conforming when SD-OCT showed a separation between the outer retina and retinal pigment epithelium. The localization of the FCE was evaluated and defined as : extrafoveal (EF) or subfoveal/juxtafoveal (SF/JF).
Results: :
The mean age of the patients was 50.6 years (range 29 to 76). All patients were caucasian, five men and two women. Mean refractive error was -2.95 diopters (range from 0 to -7,5 diopters). The mean BCVA was 0.75 (range 1.00 to 0.31). Four eyes were affected by chronic central serous chorioretinopathy, one eye had myopic choroidal neovascularization, another one had choriocapillaritis and the last two eyes reported no ocular disease. One patient was HIV positive (in therapy with anti-retroviral drugs) while the other six patients reported no history of systemic disease. Two patients were symptomatic and complained metamorphopsia, while other four patients were asymptomatic. One patient had bilateral involvement but only the left eye was symptomatic with metamorphopsia. In seven eyes (87.5%) SD-OCT showed a conforming type of FCE while only one eye (12.5%) revealed a non-conforming type of FCE. In seven eyes (87.5%) FCE involved the extrafoveal region while only one eye (12.5%) had a subfoveal/juxtafoveal FCE.
Conclusions: :
In our series of FCE cases the localization of the choroidal excavations were mostly extrafoveal (87.5%). This data is in contrast with the previous published results in which these lesions involved only the subfoveal or juxtafoveal region. Moreover we observed a possible relationship between FCE and central serous chorioretinopathy.
Keywords: retina • choroid • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)