Update: Juxtapapillary choroidal excavation with polypoidal choroidal vasculopathy - An unusual association.

Sir,

This is in reference to the article, “Juxtapillary choroidal excavation with polypoidal choroidal vasculopathy: An unusual association” by Chowdhury et al.[1] As an update, we would like to further add that this case was presented at “RISHI symposium,” a pre-conference imaging symposium clubbed with annual meeting of Vitreo-retinal Society of India (VRSI), held on November 29, 2018 at Jaipur and discussed by Dr Bailey Freund (Vitreous Retina Macula Consultants of New York, NY, USA) with inputs from Dr Jose Pulido (Mayo Clinic, Rochester, MN, USA).

The discussants presented an alternative scenario that could result in the clinical situation described. They argued that choroidal osteoma is known to typically present as a unilateral tumor affecting young adult female subjects in the peripapillary location.[2] It is also known that choroidal osteoma may be complicated by choroidal neovascularization (CNV), and the latter may be related to tumor decalcification.[3] Progressive decalcification of choroidal osteoma might play a common pathogenetic role for development of CNV and focal choroidal excavation (FCE) in these patients.[4]

Both the patient profile and the association of “choroidal excavation” with “choroidal aneurysmal dilation” as noted in our reported case are compatible with the hypothesis discussed above and add to the differential diagnosis in such cases.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.