Department of Ophthalmology, Scientific Institute San Raffaele, Vita-Salute University, Milan, Italy; and.
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Retina. 2020 Dec;40(12):2319-2324. doi: 10.1097/IAE.0000000000002765.
To describe retinal and choroidal vascular changes, and choroidal stroma variations occurring in focal choroidal excavation (FCE).
Study design was a cross-sectional case series. Consecutive patients affected by FCE and healthy controls were recruited. All patients underwent complete ophthalmologic assessment and multimodal imaging, including structural optical coherence tomography and optical coherence tomography angiography. Choroidal thickness and stromal index were calculated from structural optical coherence tomography images. Moreover, we measured vessel density values of the superficial capillary plexus, deep capillary plexus and choriocapillaris at the level of the macula.
Twenty-two patients (28 eyes; mean age 57.2 ± 16.4) and 28 control eyes (mean age of 56.5 ± 9.8) were included. Five patients (23%) were asymptomatic, whereas 17 patients (77%) complained of visual symptoms. FCE was associated with choroidal neovascularization in 10 eyes (35%). Choroidal stromal component was lower in FCE patients than controls, whereas choroidal thickness was unremarkable. Stromal index values calculated in the region proximal to the FCE was significantly lower than the values obtained from the external region. Deep capillary plexus vessel density was lower in FCE than controls. Choriocapillaris was altered in the region surrounding the FCE, whereas it was normal in the external region.
Deep capillary plexus and choriocapillaris plexus were significantly altered in FCE patients. Moreover, choroidal stroma was significantly reduced in the areas closer to FCE compared to the surrounding choroid in patients, as well as compared to healthy controls, suggesting the hypothesis of weakening of the architectural support, creating a more friable point, which can favor FCE development.
描述局限性脉络膜凹陷（FCE）中出现的视网膜和脉络膜血管变化以及脉络膜基质变化。
研究设计为横断面病例系列。连续招募了患有 FCE 和健康对照组的患者。所有患者均接受了全面的眼科评估和多模态成像，包括结构光学相干断层扫描和光相干断层扫描血管造影。从结构光学相干断层扫描图像计算脉络膜厚度和基质指数。此外，我们在黄斑水平测量了浅层毛细血管丛、深层毛细血管丛和脉络膜毛细血管的血管密度值。
共纳入 22 例患者（28 只眼；平均年龄 57.2 ± 16.4）和 28 只对照组眼（平均年龄 56.5 ± 9.8）。5 例患者（23%）无症状，17 例患者（77%）有视觉症状。10 只眼（35%）的 FCE 伴有脉络膜新生血管形成。FCE 患者的脉络膜基质成分低于对照组，而脉络膜厚度无明显差异。FCE 附近区域计算的基质指数值明显低于外部区域获得的值。FCE 患者的深层毛细血管丛血管密度低于对照组。FCE 周围区域的脉络膜毛细血管发生改变，而外部区域的脉络膜毛细血管正常。
FCE 患者的深层毛细血管丛和脉络膜毛细血管丛明显改变。此外，与周围脉络膜相比，FCE 患者靠近 FCE 的区域脉络膜基质明显减少，与健康对照组相比也是如此，这表明了结构支撑减弱的假设，形成了一个更脆弱的点，这可能有利于 FCE 的发展。
