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Primary and secondary focal choroidal excavation morphologic phenotypes, associated ocular disorders and prognostic implications
British Journal of Ophthalmology ( IF 3.7 ) Pub Date : 2023-03-01 , DOI: 10.1136/bjophthalmol-2021-319569
Pamela Capellan 1 , Luis A Gonzalez 1 , M Abdallah Mahrous 1 , Stephanie J Weiss 1 , Benjamin Botsford 1 , Tamara L Lenis 1 , Michael Ryan 1 , Anton Orlin 1 , Thanos Papakostas 1 , Szilard Kiss 1 , Donald D'Amico 1 , Kyle Kovacs 2
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Aims To characterise and classify the morphological, clinical and tomographic characteristics of focal choroidal excavation (FCE) lesions to determine their prognostic implications. Methods 36 eyes with FCE (32 patients) underwent multimodal imaging, including spectral domain optical coherence tomography and fundus autofluorescence. FCE lesions were classified into three subtypes: (1) type 1: myopic (central choroidal thickness: <100 µm), (2) type 2: suspected congenital (central choroidal thickness: 100–200 µm, without associated chorioretinal pathology) and (3) type 3: secondary or acquired (central choroidal thickness: >200 µm, with associated chorioretinal pathology). Results 80.6% of eyes were followed longitudinally (26.8±18.8 months). There were 9 type 1 FCEs (myopic), 8 type 2 FCEs (U-shaped, congenital) and 19 type 3 FCEs (V-shaped, secondary). Type 2 FCEs trended towards larger maximum widths (p=0.0563). Type 3 FCEs were associated with central serous chorioretinopathy or pachyvessels (47.4%), but were also seen in pattern dystrophy, geographic atrophy, inactive choroiditis, torpedo maculopathy and adult-onset vitelliform dystrophy. Choroidal neovascular membranes (CNVMs) were more prevalent in type 3 FCE (41.2% compared with 11.1% for type 1 FCE, p=0.251, and 0% for type 2 FCE, p=0.043). Conclusions The FCE types, stratified by central choroidal thickness, demonstrated distinct morphological characteristics and associated findings. The classification scheme held prognostic implications as type 3 FCE with V shapes were associated with other chorioretinal conditions and were more likely to develop CNVM. Data are available upon reasonable request. Study data is not in an online repository. The study consists of de-identified clinical information in a locked computer, which is being maintained as de-identified study data by the principal investigator (also the corresponding author). Reuse is permitted with the investigator's permission.

中文翻译:

原发性和继发性局灶性脉络膜开挖形态学表型、相关眼部疾病和预后意义

目的 对局灶性脉络膜缺损 (FCE) 病变的形态学、临床和断层摄影特征进行定性和分类,以确定其预后意义。方法对36只FCE眼(32例)进行多模式成像,包括光谱域光学相干断层扫描和眼底自发荧光。FCE 病变分为三种亚型:(1) 1 型:近视(中央脉络膜厚度:<100 µm),(2) 2 型:疑似先天性(中央脉络膜厚度:100-200 µm,无相关脉络膜视网膜病变)和( 3) 类型 3:继发性或获得性(中央脉络膜厚度:>200 µm,伴有脉络膜视网膜病变)。结果 80.6% 的眼进行了纵向随访(26.8±18.8 个月)。有 9 例 1 型 FCE(近视)、8 例 2 型 FCE(U 型、先天性)和 19 例 3 型 FCE(V 型、先天性)二级)。类型 2 FCE 趋向于更大的最大宽度 (p=0.0563)。3 型 FCE 与中心性浆液性脉络膜视网膜病变或厚血管 (47.4%) 相关,但也见于模式营养不良、地理萎缩、非活动性脉络膜炎、鱼雷性黄斑病变和成人发病的卵黄样营养不良。脉络膜新生血管膜 (CNVM) 在 3 型 FCE 中更为普遍(41.2% 与 1 型 FCE 的 11.1% 相比,p=0.251,2 型 FCE 为 0%,p=0.043)。结论 按中央脉络膜厚度分层的 FCE 类型表现出明显的形态学特征和相关发现。分类方案具有预后意义,因为具有 V 形的 3 型 FCE 与其他脉络膜视网膜疾病相关,并且更有可能发展为 CNVM。可根据合理要求提供数据。研究数据不在在线存储库中。该研究由锁定计算机中的去识别化临床信息组成,主要研究者(也是通讯作者)将其作为去识别化研究数据进行维护。经研究者许可可重复使用。
更新日期:2023-02-20
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