Focal Choroidal Excavation Associated with Resolved Central Serous Chorioretinopathy

Authors

• Loren W. Bennett OD, James H. Quillen VAMCFollow
• Katherine M. Mehalik OD, Private Practice, Jefferson Hills, PAFollow

Medical Subject Headings

Choroidal Diseases; Focal Choroidal Excavation; Choroid; Macula; Retinal Pigment Epithelium; Central Serous Chorioretinopathy; Optical Coherence Tomography; Pachychoroid Spectrum Disorders; Blurred Vision; Observation; Middle Aged; Case Reports

Abstract

Background: Focal choroidal excavation is a localized concavity of the choroid within the macula defined by its appearance on optical coherence tomography. The condition is typically nonprogressive and often an incidental finding. It may not impact vision, although it can be associated with other visually significant macular pathologies.

Case Report: A 48-year-old male patient presented with a recent history of blurred vision in the left eye. A dilated fundus examination revealed a discrete area of pigment mottling in the macula; both the history and clinical appearance were consistent with resolved central serous chorioretinopathy. Optical coherence tomography did not show residual subretinal fluid, but did find a small, focal indentation in the retinal pigment epithelium and choroid that was diagnosed as a focal choroidal excavation. No treatment was needed, and routine observation was recommended.

Conclusion: Focal choroidal excavation is a relatively recent anatomical finding that has emerged due to the introduction and evolution of optical coherence tomography technology. While several case reports have appeared in the literature since it was first described, it is still not well understood and may be under-reported. More research is needed on its pathophysiology and clinical significance. Due to a correlation with pachychoroid disorders and other conditions which may require treatment, eyes with focal choroidal excavation should be monitored regularly to ensure timely diagnosis and management of associated pathologies.

Recommended Citation

Bennett LW, Mehalik KM. Focal Choroidal Excavation Associated with Resolved Central Serous Chorioretinopathy. Optometric Clinical Practice. 2026; 8(1):47. https://doi.org/10.37685/uiwlibraries.2575-7717.8.1.1050

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Digital Object Identifier (DOI)

10.37685/uiwlibraries.2575-7717.8.1.1050