OPTICALLY EMPTY CHOROIDAL SPACES IN HIGH HYPEROPIA

To describe the progressive optical coherence tomography findings of atypical choroidal cavitation in the inner choroid.

Case report.

A 29-year-old asymptomatic woman was noted to display two flat translucent whitish subretinal lesions along the superotemporal arcade of the right eye, during routine retinal examination. Cross-sectional spectral domain optical coherence tomography of the choroid illustrated two hyporeflective lesions consistent with atypical choroidal cavitation of the Sattler layer, associated with corresponding thickening and bulging of the underlying choroid. En face optical coherence tomography through the lesions illustrated hyporeflectivity at the level of the inner choroid, compatible with choroidal cavitation. Progressive enlargement of these two choroidal lesions was noted with cross-sectional and en face optical coherence tomography.

Intrachoroidal cavitation has been described in association with inferior peripapillary conus in myopic eyes. Progressive enlargement of these lesions has not been noted. The lesions reported herein are atypical for choroidal cavitation because they affect a young hyperopic woman and display progression. A common pathogenesis with myopic choroidal cavitation may be possible. These lesions may be secondary to a localized bulge in the sclera, or may be a "cavernous" space secondary to a congested choroid, that is, leaking fluid.