J Korean Ophthalmol Soc.  2019 Jun;60(6):541-546. 10.3341/jkos.2019.60.6.541.

Clinical Presentations of Focal Choroidal Excavation and Results of Long-term Follow-up

• Lee SH
• Kim JH
• Kim JW
• Kim CG
• Lee DW
• Lew YJ
• Cho HJ
• Kim JY

• KMID: 2449707
• DOI: http://doi.org/10.3341/jkos.2019.60.6.541

Abstract

PURPOSE
To evaluate the clinical presentations of focal choroidal excavation and to report long-term outcomes of cases without retinal disorders at the initial presentation.
METHODS
A retrospective review of medical records was performed for patients diagnosed with focal choroidal excavation. Concomitant retinal disorders at the initial presentation were identified. In cases without retinal disorders, the development of retinal disorders during follow-up was also evaluated.
RESULTS
Forty-five eyes in 45 patients were examined in this study. Focal choroidal excavation was accompanied with retinal disorders in 16 eyes (35.6%). In the remaining 29 eyes, only focal choroidal excavation was noted without any accompanying retinal disorders. The accompanying retinal disorders included choroidal neovascularization (n = 8), central serous chorioretinopathy (n = 4), epiretinal membrane (n = 1), macular hole (n = 1), branch retinal vein occlusion (n = 1), and uveitis (n = 1). Of the 29 eyes without retinal disorders, 22 were followed up for a mean period of 33.5 ± 18.2 months. Consequently, choroidal neovascularization was found to have developed in one eye at 59 months, and subretinal fluid had developed in two eyes at 17 and 28 months, respectively.
CONCLUSIONS
Focal choroidal excavation was accompanied by retinal disorders in 35.6% of the included patients. In patients without retinal disorders, the development of a retinal disorder was noted in some eyes, suggesting the need for long-term regular follow-up in patients diagnosed with focal choroidal excavation.

Keyword

Central serous chorioretinopathy; Choroidal neovascularization; Focal choroidal excavation

MeSH Terms

Central Serous Chorioretinopathy
Choroid*
Choroidal Neovascularization
Epiretinal Membrane
Follow-Up Studies*
Humans
Medical Records
Retinal Perforations
Retinal Vein Occlusion
Retinaldehyde
Retrospective Studies
Subretinal Fluid
Uveitis
Retinaldehyde

Figure

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  Figure 1 A representative figure showing focal choroidal excavation. Note thick choroid with pachyvessels (asterisks).

• 

  Figure 2 Clinical course of a focal choroidal excavation found in 29-year-old patient. At the diagnosis, there was no retinal disorder (A). The patients were regularly followed-up. At 59 months (B-D), subretinal fluid and hemorrhage was noted on fundus examination (B). Development of choroidal neovascularization was confirmed on fluorescein angiography (C) and optical coherence tomography (D). The patient was referred to the other hospital.

• 

  Figure 3 Clinical course of a focal choroidal excavation found in 37-year-old patient. At the diagnosis, there was no retinal disorder (A). The patients were regularly followed-up. Development of subretinal fluid was noted at 17 months (B), but spontaneously resolved after 2 months (C). At 28 months (D), recurrence of subretinal fluid was noted.

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