Zheng-Yu Chen, Lei Shao, Wen-Bin Wei
Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Graefes Arch Clin Exp Ophthalmol. 2019 Oct;257(10):2111-2117. doi: 10.1007/s00417-019-04374-3. Epub 2019 Jul 4.
To investigate morphological changes of focal choroidal excavation (FCE).
The medical records of 18 FCE patients (25 eyes) were retrospectively reviewed. Clinical features as well as images of ocular fundus, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and spectral domain optical coherence tomography (OCT) were analyzed. OCT images were employed as a major criterion to evaluate the changes which occurred during the follow-up.
Of the 18 patients, 9 were male and 9 were female. The mean age was 41 ± 13.5 years. The follow-up period was 38.5 ± 24.7 (7-92) months. Thirteen patients were myopic. FCE appeared from slight pigment irregularity to yellowish white plaque. FFA revealed window defects corresponding to the lesions. Early-phase ICGA images showed hypofluorescence and medium to large choroidal blood vessels. Plaque- or dot-like hyperfluorescence was seen on late-phase images. OCT scans showed that 11 patients had unilateral FCE and 7 patients were bilaterally affected. Twenty-three eyes had a single FCE and the other two eyes had 2 excavations. FCE presented as confirming type in 21 eyes and non-confirming type in 3 eyes. Discontinuity of the interdigitation zone, ellipsoid zone, and retinal pigment epithelium/Bruch's complex zone was found. The average subfoveal choroidal thickness was 312.06 ± 66.12 μm in FCE eyes. During the follow-up, choroidal neovascularization developed in 4 patients and retinal pigment epithelium discontinuity was aggravated in one eye. No remarkable changes were found in the other eyes on B scan of the OCT images, but the volume of FCE might have changed a little.
FCE, both confirming type and non-confirming type, may keep stable during a long period of time. Choroidal neovascularization may develop at the site of FCE.
研究局限性脉络膜凹陷（FCE）的形态学变化。
回顾性分析18例FCE患者（25只眼）的病历。分析临床特征以及眼底图像、眼底荧光血管造影（FFA）、吲哚菁绿血管造影（ICGA）和谱域光学相干断层扫描（OCT）图像。以OCT图像作为评估随访期间发生变化的主要标准。
18例患者中，男性9例，女性9例。平均年龄为41±13.5岁。随访时间为38.5±24.7（7 - 92）个月。13例患者为近视。FCE表现为从轻微色素不规则到黄白色斑块。FFA显示与病变对应的窗样缺损。早期ICGA图像显示低荧光以及中到大的脉络膜血管。晚期图像上可见斑块状或点状高荧光。OCT扫描显示，11例患者为单侧FCE，7例患者为双侧受累。23只眼有单个FCE，另外两只眼有2个凹陷。FCE在21只眼中表现为确诊型，3只眼中表现为非确诊型。发现指状交叉区、椭圆体区和视网膜色素上皮/ Bruch复合体区的连续性中断。FCE眼的平均黄斑下脉络膜厚度为312.06±66.12μm。随访期间，4例患者发生脉络膜新生血管，1只眼的视网膜色素上皮连续性加重。OCT图像的B扫描在其他眼中未发现明显变化，但FCE的体积可能有轻微改变。
确诊型和非确诊型FCE在较长时间内可能保持稳定。FCE部位可能发生脉络膜新生血管。
