Focal choroidal excavation
Focal choroidal excavation 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.
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, it is classified as conforming and if there is a space it is considered as non-conforming.
Based on shape of the choroidal concavity FCE can be classified as cone-shaped, bowl-shaped, or mixed morphology. Based on the location of the lesion, it can be classified as foveal or extrafoveal.
Signs and symptoms
In FCE, visual acuity may be normal and the overlying retina may also appear normal.Etiology
The exact etiology of FCE is still unknown. It was previously considered a congenital disease, but later it was suggested that FCEs can also occur with choroidal atrophy and choroiditis.Pathophysiology
Focal choroidal excavation is a concavity in the choroidal layer of the eye without posterior staphyloma or scleral ectasia, that can be detected by optical coherence tomography. The concavity is commonly seen in the macular region. The disease is usually unilateral and not associated with any accompanying systemic diseases.Choroidal vascular disorders which cause visual symptoms, including central serous chorioretinopathy, choroidal neovascularization, and polypoidal choroidal vasculopathy may also present with focal choroidal excavation.