# Sequence of focal choroidal excavation types in a patient with bilateral central serous chorioretinopathy

## TL;DR

A 39-year-old man with bilateral vision loss showed a rare case of focal choroidal excavation changing types over time.

## Contribution

First reported case of focal choroidal excavation transitioning between conforming and nonconforming types in central serous chorioretinopathy.

## Key findings

- Focal choroidal excavation changed from conforming to nonconforming and back to conforming over 12 months.
- Incomplete retinal pigment epithelium and outer retina atrophy were observed over the excavation area.
- Pachyvessels were present in the choroid without evidence of neovascularization.

## Abstract

A 39-year-old policeman complained of decreased bilateral central vision over the
last two years. On examination, visual acuity was 20/40 and 20/400 in the right
(OD) and left eye (OS), respectively, and fundoscopy revealed a bilateral
hypopigmented macular lesion. Fluorescein and indocyanine green angiography
demonstrated leakage and hyperintense spots, respectively, within the macular
areas. At baseline, optical coherence tomography showed subretinal fluid in the
OD and a conforming focal choroidal excavation in the OS. Focal choroidal
excavation converted from conforming to nonconforming type at 4-month follow-up
and then reversed to conforming type at 12-month follow-up, and was associated
with incomplete retinal pigment epithelium and outer retina atrophy over the
area of excavation. Pachyvessels were also evidenced in the choroid, without
neovascularization. We report for the first time a case of focal choroidal
excavation that progressed from conforming to nonconforming type and then
reverted to its primary configuration (conforming type) in a patient with
concurrent bilateral central serous chorioretinopathy.