Choroidal fibrosis in secondary focal choroidal excavation detected by polarization-sensitive OCT: a report of two cases.

backgroundFocal choroidal excavation (FCE) is a rare chorioretinal abnormality with unclear pathophysiology. Identifying structural alterations in the choroid may provide insights into disease progression and potential therapeutic approaches. In this study, we aimed to evaluate fibrotic tissue within secondary FCE using polarization-sensitive optical coherence tomography (PS-OCT). CASES: Two men (aged 73 and 74 years) with secondary FCE associated with macular neovascularization (MNV) and pachychoroid spectrum disease were included. OBSERVATIONS: PS-OCT revealed distinct birefringence within the excavation area and adjacent choroid. The fibrous components showed multidirectional orientation, and in both cases fibrotic tissue was consistently observed at the excavation margins. A characteristic pattern of vertically aligned fibrous elements was identified, suggesting that fibrous tissue deposition plays a role in the structural remodeling process of secondary FCE.

conclusionsPS-OCT enables detection of fibrotic remodeling in secondary FCE, offering new insights into its pathogenesis and clinical significance. Further studies are needed to clarify the clinical implications of these findings and their potential role in disease management.