Choroidal caverns in a patient with glaucoma (case study)

The article describes a clinical case of the formation of a choroidal cavern (CC) in a patient with glaucoma. CC are associated with degenerative diseases of the retina, which is likely associated with dysfunction of the choriocapillaries and impaired retinal supply. Most often, СС are the outcome of pachychoroidal conditions and age-related macular degeneration. Patient D., 63 years old, with previously diagnosed primary open-angled glaucoma in the right eye, complained of a gradual decrease in visual acuity in that eye for several years. According to the examination, the cause of vision acuity decrease was determined as partial atrophy of the retinal layers associated with CC in the superior nasal part of the perifovea and fovea. Presumably, based on signs of a pachychoroidal state in both eyes of the patient, the formed CC is the outcome of chronic central serous chorioretinopathy: focal thickening of the choroid, vasodilatation of the Haller's layer, thinning of the choriocapillaris layer, the presence of pachychoroidal pigment epitheliopathy in the left eye. CC is the marker of choriocapillary blood flow deficiency, which is an unfavorable prognostic factor for the development of glaucoma — proved by glaucoma optic neuropathy being more advanced in the eye with CC compared to the contralateral eye.