Choroidal folds in association with papilloedema.

Chorioretinal folds (striae) in the posterior fundus were reported by Birch-Hirschfeld and Siegfried (I915) in a patient with an orbital tumour, and similar cases have been reported by other authors (Lohlein, I927; Wolter and Jampel, I957; Hedges and Leopold, I959; Wolter, I962). The folds were attributed to indentation of the globe by the orbital tumour, although similar findings may be seen with elevated orbital pressure as in thyroid ophthalmopathy (Rosen, I969) or orbital pseudotumour (personal observation). Recently there have been two reports (Norton, I969; Hyvarinen and Walsh, 1970) describing choroidal folds in patients without evidence of an orbital lesion and it was suggested that the folds had been produced by scleral contraction. The first description of choroidal striae was that of Nettleship (I884) in a patient attending the National Hospital with papilloedema. He described parallel horizontal lines in the choroid, which were broad on the temporal side but finer and shorter on the nasal side of the disc. The patient had a left-sided space-occupying lesion with gross papilloedema progressing to atrophy and the striae were attributed to choroidal scarring following the resolution of oedema. The present paper describes eight similar cases seen at the National Hospital which have been studied by fluorescein angiography.