title: Evaluation of focal choroidal excavation in the macula using swept-source optical coherence tomography.
abstract: OBJECTIVE
  To evaluate imaging findings of patients with focal choroidal excavation (FCE) in the macula using swept-source optical coherence tomography (SS-OCT) and correlate it clinically.
  
  
  METHODS
  Prospective observational case series. Eleven consecutive patients (12 eyes) with FCE were described. Data on demographics and clinical presentation were collected and imaging findings (including color photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and SS-OCT) were analyzed.
  
  
  RESULTS
  The primary diagnosis was epiretinal membrane (two eyes), choroidal neovascularization (one eye), polypoidal choroidal vasculopathy (three eyes), central serous chorioretinopathy (one eye), and dry age-related macular degeneration (two eyes). Eleven out of 12 of the lesions were conforming. One presented with a non-conforming lesion that progressed to a conforming lesion. One eye had multiFCE and two had two overlapping choroidal excavations. Using the SS-OCT, we found the choroid to be thinned out at the area of FCE but sclera remained normal. The choroidal tissue beneath the FCE was abnormal, with high internal reflectivity and poor visualization of choroidal vessels. There was loss of contour of the outer choroidal boundary that appeared to be pulled inward by this abnormal choroidal tissue. A suprachoroidal space was noted beneath this choroidal tissue and the choroidal-scleral interface was smooth. Repeat SS-OCT 6 months after presentation showed the area of excavation to be stable in size.
  
  
  CONCLUSIONS
  FCE can be associated with epiretinal membrane, central serous chorioretinopathy, and age-related macular degeneration. The choroid was thinned out in the area of FCE.
authors.affiliation: Department of Ophthalmology, Singapore National Eye Centre, Singapore.
authors.forename: F P M
authors.initials: FP
authors.lastname: Lim
authors.affiliation: 1] Department of Ophthalmology, Singapore National Eye Centre, Singapore [2] Singapore Eye Research Institute, Singapore [3] National University of Singapore, Yong Loo Lin School of Medicine, Singapore.
authors.forename: B K
authors.initials: BK
authors.lastname: Loh
authors.affiliation: 1] Department of Ophthalmology, Singapore National Eye Centre, Singapore [2] Singapore Eye Research Institute, Singapore [3] National University of Singapore, Yong Loo Lin School of Medicine, Singapore.
authors.forename: C M G
authors.initials: CM
authors.lastname: Cheung
authors.affiliation: 1] Department of Ophthalmology, Singapore National Eye Centre, Singapore [2] Singapore Eye Research Institute, Singapore [3] National University of Singapore, Yong Loo Lin School of Medicine, Singapore.
authors.forename: L S
authors.initials: LS
authors.lastname: Lim
authors.affiliation: 1] Department of Ophthalmology, Singapore National Eye Centre, Singapore [2] Singapore Eye Research Institute, Singapore [3] National University of Singapore, Yong Loo Lin School of Medicine, Singapore.
authors.forename: C M
authors.initials: CM
authors.lastname: Chan
authors.affiliation: 1] Department of Ophthalmology, Singapore National Eye Centre, Singapore [2] Singapore Eye Research Institute, Singapore [3] National University of Singapore, Yong Loo Lin School of Medicine, Singapore.
authors.forename: D W K
authors.initials: DW
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis; D015862:Choroid Diseases / Q000175:diagnosis*; D020256:Choroidal Neovascularization / Q000175:diagnosis; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D057092:Geographic Atrophy / Q000175:diagnosis; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green