Clinical Characteristics of Focal Choroidal Excavation

Objective: To evaluate the clinical characteristics of focal choroidal excavation (FCE). Methods: This was a retrospective observational case series study. The medical records of 12 patients (22 eyes) with FCE were reviewed from October 2016 to November 2017 in Jinhua Eye Hospital. All patients underwent the following examinations: Slit lamp biomicroscopy, indirect ophthalmoscopy, best corrected visual acuity (BCVA), optic coherence tomography (OCT) and ultra-wide angle laser fundus scans (Daytona). Fundus fluorescein angiography (FFA) was also performed on some patients. Results: The 12 patients included 3 females (3/12) and 9 males (9/12). The average age was 45.3±14.2 years (range from 25 to 59 years). Ten patients had bilateral involvement. Ten eyes (10/22) were emmetropic, and the others were myopic. The mean BCVA (LogMAR) was 0.18±0.11 (range from 0 to 0.5). Clinical examination and color photography showed that 17 eyes (17/22) were normal. Two eyes (2/22) had varying degrees of foveal pigment alterations or a yellowish spot at the edge of the fovea. Two eyes (2/22) showed macular edema seen as a disc and 1 eye had both macular hemorrhage and exudation. OCT scans showed that 22 eyes (22/22) had a single FCE. It was located in the subfovea in 6 eyes (6/22) and was eccentric in the other 16 eyes (16/22). In 2 eyes (2/22) with central serous choroidal retinopathy, there was no obvious change in the local choroidal depression after treatment of the hydroepithelia. Choroidal neovascularization was also present in 1 eye (1/22), after repeated anti-vascular endothelial growth factor treatment, the disease reoccured. Conclusions: Most patients have bilateral involvement and secondly, unilateral involvement. Visual acuity is normal or only moderately impaired to different degrees. FCE is related to refraction. Clinical examination shows that the fundus of most patients showed normal. When complications occur, corresponding symptoms appear. Key words: focal choroidal excavation; optical coherence tomography; imaging features