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Year : 2023  |  Volume : 3  |  Issue : 2  |  Page : 564-566

Multimodal imaging in bilateral idiopathic choroidal folds

Sarakshi Netralaya, Nagpur, Maharashtra, India

Date of Submission15-Aug-2022
Date of Acceptance09-Feb-2023
Date of Web Publication28-Apr-2023

Correspondence Address:
Shilpi Narnaware
Sarakshi Netralaya, Plot No. 19, Nagpur - 440 025, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_2022_22

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Keywords: Choroidal folds, idiopathic, multimodal imaging

How to cite this article:
Narnaware S, Bansal A, Bawankule P, Nagdeve R. Multimodal imaging in bilateral idiopathic choroidal folds. Indian J Ophthalmol Case Rep 2023;3:564-6

How to cite this URL:
Narnaware S, Bansal A, Bawankule P, Nagdeve R. Multimodal imaging in bilateral idiopathic choroidal folds. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Jun 5];3:564-6. Available from: https://www.ijoreports.in/text.asp?2023/3/2/564/374922

A 56-year-old female presented for a regular check-up. On examination, the best-corrected visual acuity in both eyes was 6/6. The anterior segment was within normal limits. Fundus examination showed choroidal folds at the macula in both eyes. Both eyes fundus photo, optical coherence tomography (OCT), retro, fundus autofluorescence (FAF), optical coherence tomography angiography (OCTA), and B-scan were done.

Except for axial length, which was in the range of hypermetropia, i.e., 20.10 mm and 20.30 mm, no other positive findings (like lesion on computed tomography (CT) scan/magnetic resonance imaging (MRI) or systemic evaluation including thyroid profile) were seen which are suggestive of secondary choroidal folds.

On various imaging modalities, various findings were noted:

  • Color fundus (CF) [Figure 1]a: Undulations of retinal pigment epithelium (RPE) involving the macula
  • OCT [Figure 1]b: Combined undulations of the retina, RPE, and choroid
  • FAF [Blue – [Figure 2]a and Green - [Figure 2]b]: Alternate hypoautofluorescent and hyperautofluorescent bands
  • Retro mode [Figure 2]c: Taut bands all over posterior pole
  • Infrared (IR) [Figure 2]d: Taut bands all over posterior pole
  • OCTA [Figure 3]a, [Figure 3]b, [Figure 3]c: Prominence of lines at choroid, chorio-capillaries, and outer retinal choroid complex was noted. At all levels, there was no evidence of any other underlying pathology
  • B-scan [Figure 3]d: Wavy retino-choroidal complex was seen at the level of the macula
Figure 1: (a and b) Color fundus photo and OCT of the right and left eye

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Figure 2: (a-d) B-FAF, G-FAF, retro mode, and infrared imaging

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Figure 3: (a-c) OCTA at the level of chorio-capillaries, choroid, and ORCC. (d) B-scan

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  Discussion Top

Choroidal folds are the striae that predominantly involve the posterior pole of the fundus. These are usually arranged parallelly in a horizontal fashion and reflect the undulations of the choroid, RPE, and neurosensory retina. These lines vary in length and width and rarely extend beyond the equator.[1],[2],[3],[4]

These lines can be idiopathic when no known cause is found[5],[6], or secondary to a variety of conditions ranging from benign conditions, i.e., acquired hyperopia, to inflammatory conditions, tumors, or post-surgery.[6],[7],[8] Multimodal imaging like FAF (studies fluorophores), Retro mode (detects alterations of RPE), and IR imaging (images sub-retinal structures) which are non-invasive modalities unlike fundus fluorescein angiography (FFA) helps in differentiating idiopathic from secondary folds without any need of further investigations.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Bowling B. Kanski's Clinical Ophthalmology: A Systematic Approach. 8th ed. Cornea; 2016.  Back to cited text no. 1
Bullock JD, Egbert PR. The origin of choroidal folds a clinical, histopathological, and experimental study. Doc Ophthalmol 1974;37:261-93.  Back to cited text no. 2
Cangemi FE, Trempe CL, Walsh JB. Choroidal folds. Am J Ophthalmol 1978;86:380-7.  Back to cited text no. 3
Dailey RA, Mills RP, Stimac GK, Shults WT, Kalina RE. The natural history and CT appearance of acquired hyperopia with choroidal folds. Ophthalmology 1986;93:1336-42.  Back to cited text no. 4
Lavinsky J, Lavinsky D, Lavinsky F, Frutuoso A. Acquired choroidal folds: A sign of idiopathic intracranial hypertension. Graefe's Arch Clin Exp Ophthalmol 2007;245:883-8.  Back to cited text no. 5
Corvi F, Capuano V, Benatti L, Bandello F, Souied E, Querques G. Atypical presentation of chorioretinal folds-related maculopathy. Optom Vis Sci 2016;93:1304-14.  Back to cited text no. 6
Jaworski A, Wolffsohn JS, Napper GA. Aetiology and management of choroidal folds. Clin Exp Optom 1999;82:169-76.  Back to cited text no. 7
Wu W, Wen F, Huang S, Luo G, Wu D. Choroidal folds in Vogt-Koyanagi-Harada disease. Am J Ophthalmol 2007;143:900-1.  Back to cited text no. 8


  [Figure 1], [Figure 2], [Figure 3]


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