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Symptomatic and morphological differences between choroidal excavations
Yuji Kumano1, Hirofumi Nagai, Hiroshi Enaida
1Ohshima Hospital of Ophthalmology, Fukuoka, Japan. yujik@car.ocn.ne.jp
Summary
Focal choroidal excavation, a rare condition, may cause vision changes due to anatomical alterations. Pathogenesis may involve choroidal vascular abnormalities from embryonic development issues.
Area of Science:
- Ophthalmology
- Medical Imaging
- Choroidal Diseases
Background:
- Focal choroidal excavation (FCE) is a rare condition requiring further investigation.
- Understanding the morphological and clinical features of FCE is crucial for diagnosis and management.
Observation:
- Two patients with FCE were analyzed using spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography.
- SD-OCT revealed specific features including the contour of the excavation involving outer retinal layers and the presence of large choroidal vessels beneath the excavation.
- One patient with metamorphopsia exhibited photoreceptor outer segment separation and inner/outer segment junction disturbance.
Findings:
- Morphological differences in FCE correlated with symptomatic variations.
- Anatomical alterations between photoreceptor tips and retinal pigment epithelium, or the excavation's location, may cause metamorphopsia.
- Large choroidal vessels beneath the excavation were consistently observed.
Implications:
- The findings suggest outward traction on the macula due to choroidal vascular abnormalities as a potential cause of FCE.
- Embryonic developmental failure of the choroid is hypothesized as the underlying pathogenesis.
- Further research into FCE pathogenesis is warranted to improve understanding and treatment strategies.
