The patient had focal choroidal excavation (FCE), right eye greater than left. There were also drusen, which were likely familial and might have been unrelated to the FCE. FCE is characterized by a concavity of the choroid without associated scleral ectasia or other changes. It is usually unilateral and is often asymptomatic. Most cases are subfoveal or juxtafoveal. Many patients have myopic maculopathy or a condition along the pachychoroid spectrum such as central serous chorioretinopathy or polypoidal choroidal vasculopathy. Our patient had pachyvessels (note the unusually large choroidal blood vessels in each eye) but did not have a significantly thickened choroid in either eye. There is no specific treatment for FCE, but it can be associated with choroidal neovascular membrane formation.
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