Choroidal excavation with polypoidal choroidal vasculopathy: a case report.
Wataru Kobayashi1, Toshiaki Abe, Hiroshi Tamai
1Department of Ophthalmology, Tohoku University Graduate School of Medical Science, Sendai, Japan.
Clinical Ophthalmology (Auckland, N.Z.)
|September 13, 2012
Summary
This case report details a rare instance of choroidal excavation co-occurring with polypoidal choroidal vasculopathy (PCV) and retinal pigment epithelium detachment (PED). Further research is needed to understand this association.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Vascular Anomalies
Background:
- Choroidal excavation is a rare finding in ophthalmology.
- Polypoidal choroidal vasculopathy (PCV) and retinal pigment epithelium detachment (PED) are distinct macular conditions.
- The co-occurrence of these conditions is not well-documented.
Observation:
- A 57-year-old woman presented with metamorphopsia and was diagnosed with serous macular detachment, drusen, exudates, and a reddish-orange lesion.
- Spectral-domain optical coherence tomography (SD-OCT) revealed choroidal excavation and PED with a notch sign.
- Fluorescein angiography (FA) showed a window defect in the PED, and indocyanine green angiography (IA) confirmed typical PCV.
Findings:
- The patient's visual acuity was preserved with anti-vascular endothelial growth factor (anti-VEGF) treatment, but the lesions showed no visible change over six months.
- This is the first reported case of choroidal excavation associated with both PED and PCV.
- The co-occurrence suggests potential shared or related pathophysiological mechanisms.
Implications:
- Choroidal excavation may be linked to a broader spectrum of macular pathologies than previously recognized.
- Careful and detailed observation is crucial for understanding and managing such complex cases.
- This case highlights the importance of comprehensive multimodal imaging in diagnosing and characterizing rare retinal conditions.
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