Correlation between focal choroidal excavation and underlying retinochoroidal disease: A pathological hypothesis from clinical observation.

PURPOSE To evaluate focal choroidal excavation (FCE) in eyes with various diseases using multimodal imaging modalities and to investigate the correlation of FCE and underlying chorioretinal diseases. METHODS This retrospective observational study included 62 eyes from 56 patients who were identified by optical coherence tomography (OCT) as having FCE. All included patients underwent comprehensive clinical examination and multimodal imaging to identify and detect the characteristics of FCE and its correlation with underlying chorioretinal diseases. RESULTS All included patients were of Chinese descent, and the median age at diagnosis was 43 years (range: 15-66). Seventy-three FCEs appeared in these included eyes. Most FCEs were formed at sites with anatomical changes caused by various chorioretinal diseases. Choroidal osteoma (CO), punctate inner choroidopathy (PIC), and central serous chorioretinopathy (CSC) were the most common etiologies of FCE. During follow-up, fourteen eyes (22.58%) exhibited a pattern change, and three eyes (4.84%) developed new-onset choroid neovascularization. CONCLUSIONS FCE is a common sign found in a variety of chorioretinal diseases. Processes that involve impairment or tissue loss of the outer retina and inner choroid and disrupt the balance of intraocular pressure and choroidal pressure due to mechanical disturbance may play a role in FCE formation.