Shu-I Yeh1, Wei-Chun Chang2, Chien-Hsiu Wu2, Yu-Wen Lan2, Jui-Wen Hsieh2, Shawn Tsai2, Lee-Jen Chen2. 1. Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: shuiyeh@gmail.com. 2. Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Nursing and Management College, Mackay Memorial Hospital, Taipei, Taiwan.
Abstract
PURPOSE: To evaluate the clinical features of peripapillary choroidal cavitation (PCC) detected by optical coherence tomography (OCT). DESIGN: Retrospective, observational case series. PARTICIPANTS: One hundred twenty-two eyes from 83 patients diagnosed with PCC by OCT database review were included in this study. METHODS: Stereoscopic color fundus photographs from eyes with PCC were reviewed by 2 independent ophthalmologists. They were masked to the refractive error, axial length, and OCT findings. MAIN OUTCOME MEASURES: Chart review and data analysis included gender, age, best-corrected visual acuity (BCVA), refractive error, axial length, clinical appearance of the peripapillary area, and associated funduscopic abnormalities. RESULTS: One hundred twenty-two eyes with PCC from 83 patients were analyzed. Among the patients, 41.8% were men and 58.2% were women. The mean age was 48.2 ± 12.6 years and mean BCVA in logarithm of the minimum angle of resolution units was 0.23 ± 0.43. The mean refractive error in spherical equivalent was -9.03 ± 5.11 diopters (D) and mean axial length (AL) was 27.36 ± 2.09 mm. With respect to refractive error, 90 eyes (73.8%) were highly myopic (≥-6.00 D), 24 eyes (19.7%) had low myopia (<-6.00 D), 5 eyes (4.1%) were emmetropic (1.00 to -1.00 D), and 3 eyes (2.6%) were hyperopic (>1.00 D). Forty eyes (32.8%) with PCC had AL of less than 26.50 mm (mean, 25.11 ± 1.07 mm; range, 22.51-26.42 mm). Patients with eyes with PCC that had low myopia, were emmetropic, and were hyperopic also were significantly older than patients with highly myopic eyes (P<0.05). Stereoscopic fundus photographs demonstrated a yellow-orange, localized, well-circumscribed peripapillary lesion in 57 (46.7%) eyes with PCC. A PCC with opening was observed in 14 (26.4%) of 53 eyes with excavated myopic conus and in 5 (7.2%) of 69 eyes without excavated myopic conus (P<0.05). CONCLUSIONS: This study demonstrated that peripapillary choroidal cavitation is common and not exclusive to highly myopic eyes. The funduscopic finding of a yellow-orange peripapillary abnormality may not be evident in all eyes with demonstrable PCC by OCT. Although its pathogenesis and pathologic significance require further investigation, PCC may be a degenerative change in aging eyes.
PURPOSE: To evaluate the clinical features of peripapillary choroidal cavitation (PCC) detected by optical coherence tomography (OCT). DESIGN: Retrospective, observational case series. PARTICIPANTS: One hundred twenty-two eyes from 83 patients diagnosed with PCC by OCT database review were included in this study. METHODS: Stereoscopic color fundus photographs from eyes with PCC were reviewed by 2 independent ophthalmologists. They were masked to the refractive error, axial length, and OCT findings. MAIN OUTCOME MEASURES: Chart review and data analysis included gender, age, best-corrected visual acuity (BCVA), refractive error, axial length, clinical appearance of the peripapillary area, and associated funduscopic abnormalities. RESULTS: One hundred twenty-two eyes with PCC from 83 patients were analyzed. Among the patients, 41.8% were men and 58.2% were women. The mean age was 48.2 ± 12.6 years and mean BCVA in logarithm of the minimum angle of resolution units was 0.23 ± 0.43. The mean refractive error in spherical equivalent was -9.03 ± 5.11 diopters (D) and mean axial length (AL) was 27.36 ± 2.09 mm. With respect to refractive error, 90 eyes (73.8%) were highly myopic (≥-6.00 D), 24 eyes (19.7%) had low myopia (<-6.00 D), 5 eyes (4.1%) were emmetropic (1.00 to -1.00 D), and 3 eyes (2.6%) were hyperopic (>1.00 D). Forty eyes (32.8%) with PCC had AL of less than 26.50 mm (mean, 25.11 ± 1.07 mm; range, 22.51-26.42 mm). Patients with eyes with PCC that had low myopia, were emmetropic, and were hyperopic also were significantly older than patients with highly myopic eyes (P<0.05). Stereoscopic fundus photographs demonstrated a yellow-orange, localized, well-circumscribed peripapillary lesion in 57 (46.7%) eyes with PCC. A PCC with opening was observed in 14 (26.4%) of 53 eyes with excavated myopic conus and in 5 (7.2%) of 69 eyes without excavated myopic conus (P<0.05). CONCLUSIONS: This study demonstrated that peripapillary choroidal cavitation is common and not exclusive to highly myopic eyes. The funduscopic finding of a yellow-orange peripapillary abnormality may not be evident in all eyes with demonstrable PCC by OCT. Although its pathogenesis and pathologic significance require further investigation, PCC may be a degenerative change in aging eyes.