Focal Choroidal Excavation: Epidemiology, Clinical Characteristics and Multimodal Imaging Findings

Area of Science:

• Ophthalmology
• Medical Imaging
• Choroid Diseases

Background:

• Focal choroidal excavation (FCE) is classified under pachychoroid spectrum diseases.
• FCE can manifest as an isolated lesion or alongside other ocular conditions.
• Understanding FCE's epidemiology and clinical presentation is essential.

Purpose of the Study:

• To investigate the epidemiology of FCE.
• To describe the clinical features of FCE.
• To analyze multimodal imaging findings in FCE patients.

Main Methods:

• A case series of 14 consecutive FCE patients.
• Diagnosis confirmed via multimodal imaging, including optical coherence tomography (OCT).
• Measurement of choroidal thickness (CT) in affected and fellow eyes.

Main Results:

• FCE occurred unilaterally and as an isolated lesion in all cases.
• Subfoveal FCE was observed in 79% of cases, with a mean maximum CT of 390 μm.
• Most patients were asymptomatic; one developed secondary neovascularization.

Conclusions:

• FCE is a rare but potentially underdiagnosed condition, possibly more prevalent in Caucasians.
• Multimodal imaging, especially OCT, is vital for FCE diagnosis.
• Further research is needed on FCE etiology and clinical progression.