Multimodal Imaging Evaluations of Focal Choroidal Excavations in Eyes with Central Serous Chorioretinopathy

Figure 1

Images from a 38-year-old man with FCE in the right eye combined with classic CSC (patient 1). The patient presented with metamorphopsia which lasted for just one day. (a) Color FP shows a yellowish FCE lesion in the fovea area. (b) AF shows a small hyperfluorescent FCE lesion. (c) Early-phase FA shows the hypofluorescent FCE lesion (yellow arrowhead) and the adjacent hyperfluorescent leakage point (red arrowhead). (d) Mid-phase ICGA shows the slight hypofluorescent FCE lesion surrounded by two hyperfluorescent areas of choroidal hyperpermeability. (e) FCE converts from conforming to nonconforming, and finally back to conforming in SD-OCT images, along with the progression of CSC. The small reconstructed 3D en face OCT image by segmentation of RPE shows the umbilicate excavation with a small bulge in the center, which appears as two conterminous excavations in B-scan OCT. (f) The EDI-OCT image shows thinning ellipsoid zone, hyperreflective tissue and thinning choroid beneath FCE (green arrowhead), suprachoroidal space (blue arrowhead), and slight inward chorioscleral interface without any ectasia. The morphology of FCE differs from image (e), because the scanning line deviates from the center of FCE. (g, h) FCE presents as a dark flow signal-absent area, surrounded by a hyperperfused area in the default choriocapillaris slab of OCTA (g), and as a hyporeflective area surrounded by the hyperreflective RPE in the corresponding en face structural OCT image (h). The intersection of green line and red line represents the macular center. The yellow arrowheads point to FCE lesion in all images. The thin white arrows indicate OCT scan direction.