To study the prevalence and three-dimensional (3-D) tomographic features of focal choroidal excavations in eyes with central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (OCT).


Prospective, cross-sectional study.


We examined 116 consecutive eyes with CSC with a prototype 3-D swept-source OCT. 3-D images of the shape of the macular area, covering 6 x 6 mm2, were reconstructed by segmentation of the outer surface of the retinal pigment epithelium (RPE).


The 3-D swept-source OCT detected focal choroidal excavations in 9 eyes (7.8%). The 3-D scanning protocol, coupled with en-face scans, allowed for clear visualization of the excavation morphology. In all 9 eyes, the excavations were located within the serous retinal detachment during the active stage and were correlated with the angiographic changes. In 5 eyes with focal excavations, unusual choroidal tissue was found beneath the excavation, bridging the bottom of the excavation and the outer choroidal boundary. Additionally, three of those five eyes showed a suprachoroidal space below the excavation, as if the outer choroidal boundary is pulled inward by this bridging tissue. The focal choroidal excavations were located within fluorescein leakage points and areas of choroidal hyperpermeability. Eyes with focal choroidal excavations were more myopic (-4.42 ± 2.92 diopters) than eyes without excavations (-0.27 ± 1.80, P = .001). Subfoveal choroidal thickness was significantly thinner (301.3 ± 60.1 µm) in eyes with focal excavations than in eyes without the excavations (376.6 ± 104.8 µm, P = .036).


Focal choroidal excavation is present in 7.8% of eyes with CSC. In CSC eyes, focal choroidal excavations may form from RPE retraction caused by focal scarring of choroidal connective tissue.

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Abdallah A Ellabban