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Peripheral leptochoroid: clinical and anatomical findings
  1. Jasmine H Francis1,2,
  2. Larissa A Habib1,
  3. David H Abramson1,2
  1. 1 Memorial Sloan Kettering Cancer Center, New York, USA
  2. 2 Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA
  1. Correspondence to Jasmine H Francis, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; francij1{at}


Background/Aims To investigate the clinical findings and anatomical characteristics of patients with a thinned peripheral choroid (leptochoroid) presenting with bilateral macular geographical hyperpigmented fundus and compare with matched controls.

Methods A retrospective, observational case series of 44 eyes (24 patients): 22 study eyes (12 study patients) with clinical findings of leptochoroid (geographical hyperpigmented fundus centred in the macula) matched with 22 control eyes (12 control patients). All eyes received enhanced depth imaging optical coherence tomography at Memorial Sloan Kettering Cancer Center. Two independent observers performed all measurements. Statistical analysis was used to correlate interobserver findings, and compare patient and eye characteristics.

Results Study patients had a female predominance and median age of 70 years. Iris colour and refractive error of these eyes were varied: 8 eyes were myopic (one of which was highly myopic with a refractive error of −9.00) and 14 eyes were emmetropic or hyperopic (up to+3.00). The best-corrected visual acuity was 20/40 or better in all study eyes. The geographical macular areas of relative hyperpigmentation correspond to normal choroidal thickness compared with controls (p=0.74). The relative hypopigmented surrounding fundus had significantly thinner choroid compared with controls (p value=0.0001). Choroidal thickness had a strong interobserver correlation (r=0.99, p<0.0001).

Conclusion Described here is a clinical entity referred to as peripheral leptochoroid. It appears as geographical hyperpigmented fundus centred in the macula, with adjacent relative hypopigmented fundus. Compared with matched normal subjects, the hyperpigmented and hypopigmented fundus correspond with equivocal and decreased choroidal thickness, respectively.

  • choroid
  • optical coherence tomography
  • retina

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  • Contributors JHF planned and conducted the study and wrote the manuscript. LAH conducted the study and gave a critical review of the manuscript. DHA gave a critical review of the manuscript.

  • Funding This study was supported by The Fund for Ophthalmic Knowledge, The New York Community Trust, Research to Prevent Blindness and Cancer Center Support Grant (P30 CA008748).

  • Competing interests None declared.

  • Patient consent All images and data are anonymised.

  • Ethics approval The institutional review board of Memorial Sloan Kettering Cancer Center approved this study.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement There is no additional unpublished data from the study.