Analysis of clinical features and SS-OCT findings in patients with focal choroidal excavation

To analyze the epidemiology, clinical features, and Swept-Source Optical Coherence Tomography findings in patients with Focal Choroidal Excavation. 97 patients with FCE were identified from 50,000 scans of 25,000 individuals who underwent SS-OCT examinations. These patients' clinical and imaging features were recorded, while data from 37 individuals with follow-up records were analyzed. FCE lesions were classified into three subtypes: (1) type 1: leptochoroid type (SFCT: <100 μm), (2) type 2: normochoroid type (SFCT: 100-200 μm), and (3) type 3: pachychoroid type (SFCT: >200 μm). A total of 108 FCEs were identified in 100 eyes, with 66 (61.1%) classified as Conforming type and 42 (38.9%) as non-conforming type. The maximum depth of FCEs in the study cohort was 96.6 ± 78.4 μm, the maximum width was 875.1 ± 960.1 μm, and choroidal thickness under FCE was 200.5 ± 191.5 μm. We observed 10 chorioretinopathy coexisting with FCE and categorized FCE based on choroidal thickness, highlighting three distinct types associated with different chorioretinopathy. Follow-up assessments revealed the relative stability of FCE and the efficacy of Anti-VEGF treatment for FCE-related CNV. Choroidal thickness playing a role in determining the specific type of FCE when combined with chorioretinopathy. Factors such as choroidal inflammation, scarring, and abnormal dilation of choroidal blood vessels may contribute to the damage or loss of outer retinal and inner choroidal tissues in FCE cases. FCE typically demonstrates stability over time, and Anti-VEGF treatment has shown efficacy in managing FCE-related CNV.