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Obata, Ryo MD, PhD; Takahashi, Hidenori MD, PhD; Ueta, Takashi MD, PhD; Yuda, Kentaro MD, PhD; Kure, Kayo MD; Yanagi, Yasuo MD, PhD

doi: 10.1097/IAE.0b013e31827b6452
Original Studies

Purpose: To describe detailed clinical features of eyes with focal choroidal excavation.

Methods: Twenty-one eyes of 17 patients with focal choroidal excavation were retrospectively studied. All eyes underwent thorough examination including funduscopy, visual field analysis, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and B-scan ultrasonography.

Results: Patients’ age ranged between 25 years and 70 years. Four patients (24%) were affected bilaterally. Spherical equivalent of refractive error ranged from 0.5 diopters to −10.0 diopters (D). Funduscopic examination showed hypopigmentation (n = 12) and yellowish plaquelike appearances (n = 2). Indocyanine green angiography showed not only filling defects at the excavation (n = 16) but also choroidal vascular hyperpermeability (n = 7) and punctate hyperfluorescent spots (n = 7). Cicatrized subretinal neovascularization was seen in three eyes. The mean follow-up period was 37 months (6–66 months). There was no change in the appearance of excavation. Central serous chorioretinopathy (n = 1) and choroidal neovascularization (n = 1) developed during follow-up.

Conclusion: Background factors and ophthalmic findings are similar to those that have been reported previously, including relatively stable findings even after a long observation and the occurrence of central serous chorioretinopathy and choroidal neovascularization. Bilateral cases are not rare in the current cohort, and choroidal vascular hyperpermeability is frequently observed in indocyanine green angiography, suggesting there were choroidal hemodynamic changes around the excavation.

Seventeen focal choroidal excavation patients, the largest series ever, were studied. It was noted that patient demography, bilaterality, and symptoms are unexpectedly variable. Although follow-up observation suggested that the excavation does not progress, it was accompanied by aberrant choroidal circulation and some patients developed central serous chorioretinopathy or choroidal neovascularization.

Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.

Reprint requests: Yasuo Yanagi, MD, PhD, Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; e-mail:

The authors declare no conflict of interest.

© 2013 by Ophthalmic Communications Society, Inc.