Morphologic features of focal choroidal excavation on spectral domain optical coherence tomography with simultaneous...

To reveal clinically relevant morphologic findings in patients with focal choroidal excavation (FCE) using enhanced depth imaging optical coherence tomography.

Thirty-one FCE lesions in 29 eyes of 26 patients (21 men, 23 eyes; 5 women, 6 eyes) were studies. In all 26 patients, color fundus photographs were obtained, and fluorescein angiography and indocyanine green angiography with simultaneous enhanced depth imaging optical coherence tomography were performed. Twenty-five eyes also underwent angiographic video recording.

Focal choroidal excavation was detected in eyes with typical age-related macular degeneration, central serous chorioretinopathy, polypoidal choroidal vasculopathy, and idiopathic choroidal neovascularization, whereas in 8 eyes, FCE was considered to be idiopathic. Morphologically, FCE lesions were classified into 3 types: cone-shaped, bowl-shaped, and mixed. The cone-shaped type was detected in 17 lesions, bowl-shaped in 8, and mixed in 6, on optical coherence tomography findings. All bowl-shaped and mixed types had retinal pigment epithelial irregularities within the FCE lesion. The cone-shaped type was not observed in eyes with typical age-related macular degeneration.

Morphologically, FCE lesions were classified into cone-shaped, bowl-shaped, and mixed types, based on optical coherence tomography findings. Focal choroidal excavation formation may be associated in part with chorioretinal diseases such as age-related macular degeneration and central serous chorioretinopathy, whereas some eyes are considered to have idiopathic FCE.