Unilateral choroidal excavation in the macula detected by spectral-domain optical coherence tomography.
OBJECTIVE
To report clinical findings of three patients with unilateral peculiar choroidal excavation in the macula detected by spectral-domain (SD) optical coherence tomography (OCT).


METHODS
Three cases with unilateral choroidal excavation in the macula detected by SD OCT. Fluorescein angiography (FA), indocyanine green angiography (IA), ultrasonography, visual field tests and multifocal electroretinography (mfERG) were performed.


RESULTS
Although all three patients complained of metamorphopsia, visual acuity and central visual field were normal in the affected eyes. SD OCT demonstrated choroidal excavation in the macula despite a normal foveal contour along the inner retinal surface. The excavation involved the outer retinal layers up to the external limiting membrane in cases 1 and 2, while only the retinal pigment epithelium was involved in case 3. The excavation corresponded to foveal pigment mottling in cases 1 and 2 and to a parafoveal yellowish fusiform lesion in case 3. The lesions appeared hypoautofluorescent and unremarkable in FA except for circumferential hyperfluorescence in case 3 and hypofluorescent in IA. B-scan ultrasonography was unremarkable. MfERG in cases 1 and 2 was normal.


CONCLUSIONS
SD OCT demonstrated two types of choroidal excavation in the macula. More case accumulation and a longer follow-up will elucidate the pathogenesis and prognosis of the lesions.
Wakabayashi
Yuka
Y
Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Japan. y-waka@med.kanazawa-u.ac.jp <y-waka@med.kanazawa-u.ac.jp>
Nishimura
Akira
A
Higashide
Tomomi
T
Ijiri
Shigeyuki
S
Sugiyama
Kazuhisa
K
D000328:Adult; D015862:Choroid Diseases / Q000175:diagnosis*; D004396:Coloring Agents; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity; D014794:Visual Fields
D004396:Coloring Agents; D007208:Indocyanine Green