title: Focal choroidal excavation: a preliminary interpretation based on clinic and review.
abstract: OBJECTIVE
  To describe the clinical and imaging characteristics associated with focal choroidal excavation (FCE), analyze the possible complication, and interpret its probable etiopathogenesis.
  
  
  METHODS
  Retrospective descriptive case series of 37 eyes of 32 patients with FCE. Findings of spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, indocyanine green angiography, and clinical features were analyzed.
  
  
  RESULTS
  All patients were Chinese. Five patients (15.6%) were bilaterally involved. Patients' ages ranged from 7 to 66y. Refractive error ranged between +2.0 D and -11.0 D. Mean best-corrected visual acuity was 0.6 (range, 0.1 to 1.2). Fundus examinations exhibited mild-moderate localized pigmentary disturbances in the corresponding area of 17 eyes. Fluorescein angiography performed in 18 patients showed varying degrees of hyperfluorescence and hypofluorescence related to a range of retinal pigment epithelium (RPE) alterations. Indocyanine green angiography performed in 7 patients showed hypofluorescence at the excavation. SD-OCT demonstrated choroidal excavation in all 37 eyes. Twenty-nine eyes showed a single lesion of FCE, and three eyes showed 2-3 separated lesions. Fifteen eyes showed separation between the photoreceptor tips and RPE consistent with nonconforming FCE. Central serous chorioretinopathy (CSC, n=1) and choroidal neovascularization (CNV, n=1) developed during follow-up.
  
  
  CONCLUSIONS
  FCE could be interpreted as congenital focal choroidal dysplasia involving the RPE, choriocapillaris, and photoreceptor associated with the faulty anatomy. The abnormal anatomy of FCE was similar to anatomy at risk of CSC and CNV.
authors.affiliation: School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China ; Department of Ophthalmology, Affiliated People's Hospital to Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian Province, China.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Liu
authors.affiliation: School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Xin-Quan
authors.initials: XQ
authors.lastname: Sun
authors.affiliation: School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Zi-Fang
authors.initials: ZF
authors.lastname: He
authors.affiliation: School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Ji-Rong
authors.initials: JR
authors.lastname: Li
authors.affiliation: School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhou
authors.affiliation: School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Liu
keywords: dysplasia; etiology; focal choroidal excavation; optical coherence tomography