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   Table of Contents      
PHOTO ESSAY
Year : 2019  |  Volume : 67  |  Issue : 3  |  Page : 400-401

Juxtapapillary Focal Choroidal Excavation


Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

Date of Submission03-Aug-2018
Date of Acceptance27-Oct-2018
Date of Web Publication18-Feb-2019

Correspondence Address:
Dr. Shorya Vardhan Azad
Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1299_18

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  Abstract 


Keywords: Focal choroidal excavation, juxtapapillary FCE, SS-OCT


How to cite this article:
Agarwal P, Roy S, Azad SV, Kumar V. Juxtapapillary Focal Choroidal Excavation. Indian J Ophthalmol 2019;67:400-1

How to cite this URL:
Agarwal P, Roy S, Azad SV, Kumar V. Juxtapapillary Focal Choroidal Excavation. Indian J Ophthalmol [serial online] 2019 [cited 2019 Mar 20];67:400-1. Available from: http://www.ijo.in/text.asp?2019/67/3/400/252406



Focal choroidal excavation (FCE) was first discovered incidentally by Jampol et al. in a case having choroiditis.[1] The term FCE was later coined by Margolis.[2] Swept-source optical coherence tomography (SS-OCT) with enhanced depth imaging is ideal for diagnosing FCE. Herein, we describe a rare case of juxtapapillary FCE.


  Case Report Top


A 30-year-old male presented with complaints of blurring of vision in both eyes since 10 years. Patient was diagnosed and operated for developmental cataract in both eyes elsewhere. Best-corrected vision at presentation was 20/40 and 20/30 in left eye and right eye, respectively. On anterior segment examination, pseudophakia with mild posterior capsular opacification (PCO) was present in both eyes. Intraocular pressure was within normal limits. Fundus examination showed normal disk in both eyes. Inferotemporal to disk, a black, circular, sharply demarcated, subretinal lesion was noted in left eye [Figure 1]a. SS-OCT scan through the lesion revealed an FCE of conforming type [Figure 1]b and [Figure 1]c. No subretinal fluid or membrane was associated with it. Patient was advised regular follow-up and counseled to report earlier in case of metamorphopsia and blurring of vision.
Figure 1: (a) Fundus photo of right eye showing a black, circular, sharply demarcated, subretinal lesion, inferotemporal to disk. (b and c) SS-OCT scan through the lesion revealing a focal choroidal excavation of conforming type

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  Discussion Top


FCE is a relatively new finding corroborated on OCT. It is believed to be a defect in development of the eyeball. Two types have been described, conforming and nonconforming, our case being the former. Previously thought to be indolent, recent literature suggests its association with central serous chorio-retinopahty, choroidal neovascular membrane, and polypoidal choroidal vasculopathy.[3],[4] Given that aforementioned complications may have vision-compromising consequences, a regular follow-up is recommended. Foveal and extrafoveal FCE has been regularly reported, but juxtapapillary FCE has only been reported once in the literature, that too incidentally diagnosed.[5] Thus, it may be prudent to keep FCE in differential of a juxtapapillary lesion.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jampol LM, Shankle J, Schroeder R, Tornambe P, Spaide RF, Hee MR. Diagnostic and therapeutic challenges. Retina Phila Pa 2006;26:1072-6.  Back to cited text no. 1
    
2.
Margolis R, Mukkamala SK, Jampol LM, Spaide RF, Ober MD, Sorenson JA, et al. The expanded spectrum of focal choroidal excavation. Arch Ophthalmol 2011;129:1320-5.  Back to cited text no. 2
    
3.
Suzuki M, Gomi F, Hara C, Sawa M, Nishida K. Characteristics of central serous chorioretinopathy complicated by focal choroidal excavation. Retina Phila Pa 2014;34:1216-22.  Back to cited text no. 3
    
4.
Kobayashi W, Abe T, Tamai H, Nakazawa T. Choroidal excavation with polypoidal choroidal vasculopathy: A case report. Clin Ophthalmol Auckl NZ 2012;6:1373-6.  Back to cited text no. 4
    
5.
Suzuki M, Gomi F, Hara C, Sawa M, Nishida K. Characteristics of central serous chorioretinopathy complicated by focal choroidal excavation. Retina Phila Pa 2014;34:1216-22.  Back to cited text no. 5
    


    Figures

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