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Ghadiali, Quraish, MD*,†; Dansingani, Kunal K., MA, FRCOphth*,†,‡; Freund, K. Bailey, MD*,†

Retinal Cases and Brief Reports: October 2016 - Volume 10 - Issue 4 - p 293–296
doi: 10.1097/ICB.0000000000000301
Case Report

Purpose: To report a case of focal choroidal excavation and choroidal neovascularization in the setting of pachychoroid disease.

Methods: Multimodal imaging, including fundus photography, fundus autofluorescence, enhanced depth imaging optical coherence tomography, indocyanine green angiography, and en face structural and angiographic optical coherence tomography.

Results: The authors describe a 39-year-old female with moderately high myopia presenting with focal choroidal excavation and associated choroidal neovascularization. Multimodal imaging demonstrated pachychoroid features with dilated choroidal vessels surrounding the lesion. Optical coherence tomography angiography showed Type 2 neovascularization.

Conclusion: Some cases of focal choroidal excavation and associated neovascularization may be related to structural abnormalities of the associated choroidal vasculature.

Focal choroidal excavation with an acute neovascular process is demonstrated in the setting of pachychoroid disease. Using multimodal imaging, dilated choroidal vessels are observed surrounding an area of choroidal thinning with associated excavation and neovascularization.

*Vitreous Retina Macula Consultants of New York, New York, New York;

The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; and

Moorfields Eye Hospital, London, United Kingdom.

Reprint requests: K. Bailey Freund, MD, Vitreous Retina Macula Consultants of New York, 460 Park Avenue, 5th floor, New York, NY 10022; e-mail:

This research was supported by a grant provided by the Macula Foundation, Inc. The funding organization played no role in the design or conduct of this study.

K. B. Freund is a consultant for Genentech, ThromboGenics, Optovue, Optos, Bayer Healthcare, and Heidelberg Engineering. The remaining authors have no conflicting interests to disclose.

© 2016 by Ophthalmic Communications Society, Inc.