# Long-term follow-up demonstrates change in conformation shape of the focal choroidal excavation lesions

## TL;DR

This study tracks changes in focal choroidal excavation lesions over time, showing they can shift between conforming and non-conforming types.

## Contribution

The study reveals that focal choroidal excavation lesions can change shape over time, including spontaneous and treatment-induced transitions.

## Key findings

- All 5 patients showed conversion between conforming and non-conforming focal choroidal excavation types.
- Four cases transitioned from non-conforming to conforming FCE, with three occurring spontaneously.
- Changes in lesion shape were considered non-pathologic and clinically insignificant.

## Abstract

This study aims to present long-term observation of 5 eyes with focal choroidal excavation (FCE), focusing on morphological changes in conformity of the lesion.

A retrospective case series was conducted, including 5 eyes of 5 patients with FCE. The study utilized multimodal imaging including color fundus photography, optical coherence tomography (OCT), enhanced depth imaging OCT (EDI-OCT), fundus fluorescein angiography (FFA), fundus autofluorescence (FAF), red free imaging, and OCT angiography.

The mean age at diagnosis was 51 ± 10.65 years, with a mean follow-up period 37 ± 13.59 months. All cases were unilateral, with 1 presenting FCE as an isolated lesion, and one patient exhibiting 2 FCEs in one eye. The mean choroidal thickness measured by EDI-OCT was 268.2 ± 63.39 μm in the affected eye. One patient displayed choroidal thickening and pachyvessels. Of the 5 eyes, one had conforming and 4 non-conforming FCE. We observed a conversion in conformity in all patients, with 4 cases transitioning from non-conforming FCE to conforming type (3 spontaneously, 1 treatment-induced). In conforming FCE, a hyporeflective space appeared twice between neuroretina and retinal pigment epithelium with spontaneous regression.

We observed change in shape from the conforming to non-conforming FCE and vice versa in all patients. We consider this small change in the hyporeflective space as non-pathologic and clinically insignificant.