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Prevalence and clinical correlates of focal choroidal excavation in eyes with age-related macular degeneration, polypoidal choroidal vasculopathy and central serous chorioretinopathy
  1. Fiona Pin Miao Lim1,
  2. Chee Wai Wong1,
  3. Boon Kwang Loh1,
  4. Choi Mun Chan1,2,
  5. Ian Yeo1,2,3,4,
  6. Shu Yen Lee1,2,3,4,
  7. Ranjana Mathur1,2,
  8. Doric Wong1,2,
  9. Tien Yin Wong1,2,3,4,
  10. Chui Ming Gemmy Cheung1,2,3,4
  1. 1Singapore National Eye Centre, Singapore, Singapore
  2. 2Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
  3. 3Singapore Eye Research Institute, Singapore, Singapore
  4. 4Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  1. Correspondence to Dr Chui Ming Gemmy Cheung, Vitreoretinal Service, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; gemmy.cheung.c.m{at}snec.com.sg

Abstract

Purpose To describe the prevalence and clinical characteristics of focal choroidal excavation (FCE) in patients with exudative maculopathy due to age-related macular degeneration with choroidal neovascularisation (AMD-CNV), polypoidal choroidal vasculopathy (PCV) and central serous chorioretinopathy (CSC).

Methods Three hundred and forty-three patients (343 presenting eyes and 255 fellow unaffected eyes) from consecutive patients presenting with untreated AMD-CNV, PCV or CSC are prospectively recruited. Two independent retinal specialists masked to the clinical diagnosis graded the presence of FCE by examining the findings from spectral-domain optical coherence tomography (SD-OCT). The frequency and clinical characteristics of FCE in each of the three clinical diagnosis groups were compared.

Results The diagnosis in the presenting eye was AMD-CNV in 92 patients, PCV in 149 patients, retinal angiomatous proliferation (RAP) in 3 patients and CSC in 99 patients; 255 fellow eyes free of clinical diseases were also graded. The prevalence of FCE was 2.3% (total 14 eyes; 10 presenting eyes, 4 fellow eyes) out of 598 eyes examined. In presenting eyes, FCE was most prevalent in PCV (6.0%), followed by AMD-CNV (1.0%) and CSC (0%), p=0.02. In fellow eyes, the prevalence of FCE was 2.9%, 0% and 1.2% in patients with PCV, AMD-CNV and CSC, respectively. Eyes with FCE had a significantly longer axial length (24.93±1.65 mm vs 23.49±1.10 mm, p<0.001), but otherwise, all other characteristics were similar.

Conclusions FCE is more common in PCV than AMD-CNV and CSC. Disturbance in the choroid/retinal pigment epithelium/Bruch membrane interface affected by FCE may be linked to the pathogenesis of PCV and AMD-CNV.

  • Retina
  • Imaging
  • Choroid

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