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   Table of Contents      
OPHTHALMIC IMAGE
Year : 2020  |  Volume : 68  |  Issue : 10  |  Page : 2262

Focal choroidal excavation with macular hole in a case of advanced retinitis pigmentosa


1 Department of Vitreo-Retina, Gomabai Netralaya, Neemach, Madhya Pradesh, India
2 Department of Vitreo-Retina, B. W. Lions Superspeciality Eye Hospital, Bengaluru, Karnataka, India
3 Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India

Date of Web Publication23-Sep-2020

Correspondence Address:
Dr. C K Nagesha
Department of Vitreo-Retina, B. W. Lions Superspeciality Eye Hospital, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_141_20

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How to cite this article:
Hirawat RS, Nagesha C K, Poddar C. Focal choroidal excavation with macular hole in a case of advanced retinitis pigmentosa. Indian J Ophthalmol 2020;68:2262

How to cite this URL:
Hirawat RS, Nagesha C K, Poddar C. Focal choroidal excavation with macular hole in a case of advanced retinitis pigmentosa. Indian J Ophthalmol [serial online] 2020 [cited 2020 Oct 31];68:2262. Available from: https://www.ijo.in/text.asp?2020/68/10/2262/295666



A 32-old lady presented with light perception vision in both eyes. Fundus examination of both eyes showed arteriolar attenuation and bone specule pigmentation throughout suggestive of retinitis pigmentosa. Left eye showed an yellowish-white punched-out lesion at macula [[Figure 1]a, asterisk] with an overlying macular hole. Optical coherence tomography (OCT) scan through the macula revealed focal choroidal excavation (FCE) of nonconforming type with full thickness macular hole [Figure 1]b.
Figure 1: Fundus photograph of the left eye (a) showing features of advanced RP. OCT showing a full thickness macular hole with underlying choroidal excavation (b)

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FCE is described in association with pachychoroid, North Carolina dystrophy and rubella.[1],[2],[3] Chronic intraocular inflammation has been observed in RP.[4] This inflammation could have caused disruption of the choroidal stroma leading onto atrophy and excavation. This entity should be differentiated from intrachoroidal cavitations seen in myopia in which there is posterior bowing of the sclera with retino-choroidal coning,[5] and macular coloboma where the defect is layered by undifferentiated retinal tissue.

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.
Chung CY, Li SH, Li KKW. Focal choroidal excavation-morphological features and clinical correlation. Eye (Lond) 2017;31:1373-9.  Back to cited text no. 1
    
2.
Parodi MB, Romano F, Montagna M, Bandello F. Large choroidal excavation in a patient with rubella retinopathy. Eur J Ophthalmol 2018;28:251-2.  Back to cited text no. 2
    
3.
Schoenberger SD, Agarwal A. Intrachoroidal cavitation in North Carolina macular dystrophy. JAMA Ophthalmol 2013;131:1073-6.  Back to cited text no. 3
    
4.
Yoshida N, Ikeda Y, Notomi S, Ishikawa K, Murakami Y, Hisatomi T, et al. Clinical evidence of sustained chronic inflammatory reaction in retinitis pigmentosa. Ophthalmology 2013;120:100-5.  Back to cited text no. 4
    
5.
Ohno-Matsui K, Akiba M, Moriyama M, Ishibashi T, Hirakata A. Intrachoroidal cavitation in macular area of eyes with pathologic myopia. Am J Ophthalmol 2012;154:382-93.  Back to cited text no. 5
    


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