Focal Choroidal Elevations: Localized Pigment Epithelial Contour Alterations due to Isolated Choroidal Vessels

Area of Science:

• Ophthalmology
• Retinal Imaging
• Choroidal Diseases

Background:

• Focal choroidal elevations (FCE) represent chorioretinal contour changes.
• These changes are associated with individual choroidal vessels within a thin choroid.

Purpose of the Study:

• To describe the clinical and imaging features of focal choroidal elevations (FCE).
• To differentiate FCE from other chorioretinal conditions.

Main Methods:

• Screening of 787 enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT) images.
• Prospective analysis of 38 patients with FCE, recording demographics, choroidal thickness, and associated conditions.
• Ophthalmoscopic findings and fellow eye choroidal neovascularization (CNV) were documented.

Main Results:

• FCE were found in 25 patients with age-related macular degeneration (ARMD), 5 with high myopia, and 8 with age-related choroidal atrophy (ARCA).
• Mean central macular choroidal thickness (CMCT) was 86 ± 40 μm.
• Mean lumen diameter of the vessels causing FCE was 131 ± 33 μm.

Conclusions:

• FCE are frequently observed in elderly patients with ARMD, high myopia, and ARCA.
• FCE possess distinct imaging morphology differing from chorioretinal folds.
• These lesions may be misidentified as pigment epithelial detachments and can be associated with fellow eye CNV.