Characteristics of Peripapillary Choroidal Caitation Detected by Optical Coherence Tomography

Shu-I Yeh

Purpose: To evaluate the clinical features of peripapillary choroidal cavitation (PCC) detected by optical coherence tomography.

Method: Retrospective chart review of eyes with PCC detected by optical coherence tomography was performed. Data analysis included sex, age, best-corrected visual acuity (BCVA), refractive error, axial length, presence or not of a yellow-orange peripapillary lesion or any other associated fundoscopic abnormalities.

Results: 122 eyes with PCC from 83 patients were analyzed. 41.8% were men and 58.2% were women. The mean age was 48.2 ± 12.6 years and mean BCVA in log MAR was 0.23 ± 0.43. The mean refractive error in spherical equivalent (SE) was -9.03 ± 5.11D and mean axial length (AL) was 27.36 ± 2.09 mm. Regarding refractive error, 90 (73.8%) eyes have high myopia, 24 (19.7%) low myopia, 5 (4.1%) emmetropia and 3 (2.6%) hyperopia. 40 (32.8%) eyes with PCC have AL < 26.50 mm (mean 25.11 ± 1.07 mm, range 22.51-26.42 mm). Eyes with PCC that were low myopic, emmetropic and hyperopic occurred in patients aged significantly older than high myopic ones. Indirect ophthalmoscopy revealed the presence of a typical yellow-orange, localized, well circumscribed peripapillary lesion 57 (46.7%) eyes with PIC. The fundoscopic finding of a typical yellow-orange patchy lesion was not indicative of the OCT findings of intrachoroidal schisis or cavitation, nor was it correlated with patient's age, axial length or refractive error (P>0.05, Mann–Whitney U test). PCC with opening was observed in 14 of 53 eyes (26.4%) with excavated myopic conus, and in 5 of 69 eyes (7.2%) without excavated myopic conus. This difference was statistically significant (P<0.05, Fisher exact probability test)

Conclusion: The findings of this study indicate that PCC is not uncommon and it is not exclusive among highly myopic eyes. The presence of a typical yellow-orange peripapillary retinal lesion might not be an evident fundoscopic feature for all eyes with demonstrable PCC by optical coherence tomography. Although its pathogenesis and pathologic significance require further investigation, PCC might be a degenerative change in aging eyes.