Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA.
Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA
Br J Ophthalmol. 2023 Mar;107(3):373-379. doi: 10.1136/bjophthalmol-2021-319569. Epub 2021 Oct 16.
To characterise and classify the morphological, clinical and tomographic characteristics of focal choroidal excavation (FCE) lesions to determine their prognostic implications.
36 eyes with FCE (32 patients) underwent multimodal imaging, including spectral domain optical coherence tomography and fundus autofluorescence. FCE lesions were classified into three subtypes: (1) type 1: myopic (central choroidal thickness: <100 µm), (2) type 2: suspected congenital (central choroidal thickness: 100-200 µm, without associated chorioretinal pathology) and (3) type 3: secondary or acquired (central choroidal thickness: >200 µm, with associated chorioretinal pathology).
80.6% of eyes were followed longitudinally (26.8±18.8 months). There were 9 type 1 FCEs (myopic), 8 type 2 FCEs (U-shaped, congenital) and 19 type 3 FCEs (V-shaped, secondary). Type 2 FCEs trended towards larger maximum widths (p=0.0563). Type 3 FCEs were associated with central serous chorioretinopathy or pachyvessels (47.4%), but were also seen in pattern dystrophy, geographic atrophy, inactive choroiditis, torpedo maculopathy and adult-onset vitelliform dystrophy. Choroidal neovascular membranes (CNVMs) were more prevalent in type 3 FCE (41.2% compared with 11.1% for type 1 FCE, p=0.251, and 0% for type 2 FCE, p=0.043).
The FCE types, stratified by central choroidal thickness, demonstrated distinct morphological characteristics and associated findings. The classification scheme held prognostic implications as type 3 FCE with V shapes were associated with other chorioretinal conditions and were more likely to develop CNVM.
描述和分类局灶性脉络膜凹陷（FCE）病变的形态学、临床和断层特征，以确定其预后意义。
36 只眼（32 例患者）接受了多模态成像，包括频域光学相干断层扫描和眼底自发荧光。FCE 病变分为三型：（1）1 型：近视（中心脉络膜厚度：<100μm）；（2）2 型：疑似先天性（中心脉络膜厚度：100-200μm，无相关脉络膜视网膜病变）；（3）3 型：继发性或获得性（中心脉络膜厚度：>200μm，伴有相关脉络膜视网膜病变）。
80.6%的眼进行了纵向随访（26.8±18.8 个月）。9 只眼为 1 型 FCE（近视性），8 只眼为 2 型 FCE（U 形，先天性），19 只眼为 3 型 FCE（V 形，继发性）。2 型 FCE 的最大宽度有增大趋势（p=0.0563）。3 型 FCE 与中心性浆液性脉络膜视网膜病变或脉络膜增厚有关（47.4%），但也见于图案性营养不良、地图状萎缩、静止性脉络膜炎、鱼雷黄斑病变和成人型卵黄样黄斑营养不良。3 型 FCE 中脉络膜新生血管膜（CNVM）更为常见（41.2%比 1 型 FCE 的 11.1%，p=0.251，2 型 FCE 的 0%，p=0.043）。
根据中心脉络膜厚度分层的 FCE 类型显示出不同的形态学特征和相关发现。分类方案具有预后意义，因为 V 形的 3 型 FCE 与其他脉络膜视网膜疾病有关，并且更有可能发展为 CNVM。
