Focal choroidal excavation

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Focal choroidal excavation
SpecialtyOphthalmology
Diagnostic methodoptical coherence tomography
TreatmentUsually observation without treatment

Focal choroidal excavation (FCE) is a concavity in the choroidal layer of the eye that can be detected by optical coherence tomography. The disease is usually unilateral and not associated with any accompanying systemic diseases.

Pathophysiology

Focal choroidal excavation (FCE) is a concavity in the choroidal layer of the eye without posterior staphyloma or scleral ectasia, that can be detected by optical coherence tomography.[1] The concavity is commonly seen in the macular region.[2] The disease is usually unilateral and not associated with any accompanying systemic diseases.[3]

Choroidal vascular disorders which cause visual symptoms, including central serous chorioretinopathy (CSCR), choroidal neovascularization (CNV), and polypoidal choroidal vasculopathy (PCV) may also present with focal choroidal excavation.[3]

Etiology

The exact etiology of FCE is still (as of 2022) unknown.

choroiditis.[4]

Signs and symptoms

In FCE, visual acuity may be normal and the overlying retina may also appear normal.[4][5]

Classification

There are three types of classification systems used to classify FCE.

If there is no separation between photoreceptor outer segments and the retinal pigment epithelium (RPE), it is classified as conforming and if there is a space it is considered as non-conforming.[6]

Based on shape of the choroidal concavity FCE can be classified as cone-shaped, bowl-shaped, or mixed morphology.[6] Based on the location of the lesion, it can be classified as foveal or extrafoveal.[6]

Treatment

Asymptomatic FCE without any other choroidal or retinal changes, observation is only recommended.[6] If the lesion expands or the sclera thickens, rule out other underlying causes and treat it.[6]

History

Jampol et al. first identified the lesion in 2006.[3] Margolis et al. named the condition as focal choroidal excavation.[3] Later Shinojima et al. described a classification system based on shape of the choroidal concavity.[6]

References

  1. PMID 25190653. Archived
    from the original on 2018-06-02. Retrieved 2022-08-18.
  2. S2CID 221126332. Archived
    from the original on 2022-08-18. Retrieved 2022-08-18.
  3. ^
    PMID 28050329
    .
  4. ^
    PMID 28452991
    .
  5. ISSN 2409-5680. Archived
    from the original on 2020-06-29. Retrieved 2022-08-18.
  6. ^ a b c d e f "Focal Choroidal Excavation (FCE) - EyeWiki". eyewiki.aao.org. Archived from the original on 2022-09-14. Retrieved 2022-08-18.
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