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

Figure 3

Images from a 39-year-old woman with FCE combined with chronic CSC in the left eye (patient 16) and a 43-year-old man with FCE combined with classic CSC in the left eye (patient 13). Nonconforming FCEs in both patients remained nonconforming despite the resolution of SRD. BCVA of both patients were 20/20. (a~f) Patient 16. () Patient 13. (a, g) The two cone-shaped FCEs remain nonconforming in B-scan OCT, and a hyperreflective material (a) and a hyporeflective space (g) can be found between photoreceptor tips and RPE, respectively, in patients 16 and 13. (b, c, h, i) FCEs present as a dark flow signal-absent area surrounded by hyperperfused area in the default choriocapillaris slab of OCTA (b, h) and as a hyporeflective area surrounded by hyperreflective RPE in the corresponding en face structural OCT images (c, i). (d, j) MSI 810 nm shows the well-defined dark teardrop FCE lesion in patient 16 (d). MSI 850 nm shows the grayish FCE lesion with blurred margin in patient 13 (j). (e, f) Superficial (e) and deep (f) retinal plexus seemed almost undisturbed in OCTA. (k) Mid-phase ICGA shows the mild hypofluorescent FCE lesion close to hyperfluorescent areas of choroidal hyperpermeability. The FCE lesion is distant from the leakage point (red arrowhead). (l) FCE can be accurately localized according to the default en face structural OCT image of outer retina slab, based on the distinct positional relationship between FCE and projection artifacts of retinal vessels. The yellow arrowheads point to FCE lesion in all images. The thin white arrows indicate OCT scan direction.

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