title: Chorioretinal folds: associated disorders and a related maculopathy.
abstract: OBJECTIVE
  To describe a series of chorioretinal folds (CRFs) representing a clinical sign that may be associated with multiple systemic, orbital, and ophthalmologic disorders. We report the associations with systemic disease and describe 3 stages of a CRF-related maculopathy.
  
  
  METHODS
  Observational, retrospective case series.
  
  
  METHODS
  We reviewed 57 affected eyes from 40 patients with the clinical sign of CRF from 1 of 2 academic institutions. A careful review of the medical histories and systemic diagnostic evaluations were conducted. Imaging studies were conducted.
  
  
  RESULTS
  The mean age at diagnosis was 64 ± 17 years. Most eyes (n = 18) were hyperopic (+2.60 ± +2.90 diopters). There were 20 patients (50%) with some form of autoimmune disorder. Overall, the mean presenting visual acuity was 20/50, declining slightly to 20/60 over 19 ± 30 months. Ten eyes had stage 3 CRF-related maculopathy, more common in older individuals with more chronic CRFs. Four stage 3 eyes had associated choroidal neovascularization, and these eyes had 20/60 presenting visual acuity that decreased to 20/100 over approximately 1.5 years. Stage 3 eyes without choroidal neovascularization had a mean presenting visual acuity of 20/40 that decreased to 20/65 over 2.1 years.
  
  
  CONCLUSIONS
  CRFs are associated with numerous ophthalmic and systemic disorders. A careful medical history and evaluation are essential. We describe 3 stages of a unique CRF-related maculopathy. Stage 3 resembles occult choroidal neovascularization, occurs primarily in older individuals with chronic CRFs, and is accompanied by a slow deterioration in central acuity.
authors: Department of Ophthalmology, Emory University, Atlanta, Georgia. Electronic address: tolsen@emory.edu.
authors: Timothy W
authors: TW
authors: Olsen
authors: Department of Ophthalmology, Emory University, Atlanta, Georgia.
authors: Neal V
authors: NV
authors: Palejwala
authors: Department of Ophthalmology, Emory University, Atlanta, Georgia.
authors: Lyndon B
authors: LB
authors: Lee
authors: Department of Ophthalmology, Emory University, Atlanta, Georgia.
authors: Chris S
authors: CS
authors: Bergstrom
authors: Department of Ophthalmology, Emory University, Atlanta, Georgia.
authors: Steven
authors: S
authors: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology