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Medknow Publications, Oman Journal of Ophthalmology, 2(5), p. 126

DOI: 10.4103/0974-620x.99381

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An unusual pattern of idiopathic choroidal folds

Journal article published in 2012 by Neha Goel, Vinod Kumar, Usha Kaul Raina, Basudeb Ghosh
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Choroidal folds are parallel grooves or striae in the fundus, which may be idiopathic or associated with a variety of conditions. They are seen ophthalmoscopically and on angiography as alternating light and dark streaks oriented horizontally at the posterior pole. Less commonly vertical, oblique, or irregular alignment may be seen. [1] We describe an unusual pattern of bilateral idiopathic choroidal folds present circumferentially around the posterior pole. A 50-year-old nonsmoker female presented with the complaint of blurring in her left eye since 3 weeks. She had no significant ocular or medical history. Her corrected visual acuity was 20/20 in the right eye and 20/30 in the left eye. She had normal anterior segments and pupillary reactions with intraocular pressure of 14 mm Hg in both the eyes. There was no proptosis or restricted ocular movements. Dilated fundus examination revealed pigmentary changes inferotemporal to the macula in the right eye [Figure 1a] and neurosensory detachment at the macula in the left eye [Figure 1b]. In addition, choroidal folds were noted, present circumferentially around the arcades, in both eyes [Figures 1a, b]. The optic discs were unremarkable. Fluorescein angiography showed a window defect corresponding to the area of pigmentary disturbance in the right eye [Figure 2a] and an inkblot type of leak subfoveally in the left eye [Figure 2b]. The folds were seen prominently owing to their classic alternating hypo and hyperfluorescence [Figures 2a-c]. Optical coherence tomography revealed a shallow neurosensory detachment in the left eye. B-scan ultrasonography was normal in both eyes, notable for the absence of any mass or flattening of the posterior pole. Axial length measurement by A-scan ultrasonography was 22.56 mm in the right and 22.48 mm in the left eye. Computed tomography (CT) of the orbits showed no evidence of an intraorbital mass or posterior flattening of the globes.