Multimodal imaging of a choroidal subfoveal macrovessel

Author: Andrés López-Jimenez (Spain)

Co-authors: Francisco José Pozo-Lorenzo, Miriam Pastor-Montoro, Cristina Gómez-Sánchez, María Ángeles Perea-Riquelme

Purpose

To describe the clinical and multimodal imaging features in a case of choroidal macrovessel (CM).

Setting/Venue

Hospital General Universitario Reina Sofia de Murcia.

Methods

Multimodal imaging features, including fundus photography (FP), near infrared reflectance, autofluorescence (FAF), spectral domain optical coherence tomography (OCT) with enhanced depth imaging (EDI), angiography by optical coherence tomography (OCT-A), B-scan ultrasonography (US) and fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).

Results

An 80-year-old man with hypertension and type II diabetes came to routinary examination. His best corrected visual acuity was 1 in both eyes and the anterior pole was normal. The fundoscopy was normal in the right eye and showed a slightly raised macula with discrete pigmentary changes in the left eye. FAF showed mottled hyperautofluorescence in this area, US was normal, FFA showed the presence of a great vessel beneath the fovea, with focal increased hyperfluorescence in late times. OCT showed a round hyporreflective area in the fovea corresponding to the CM, with mild elevation of the retina, alteration of the outer retinal layers and a thickened choroid. No subretinal fluid was observerd. OCT en face highlighted the inferior-temporal course of the CM from the fovea. OCT-A confirmed the existence of a subfoveal macrovessel at the choroidal level, with a great caliber, a hyporreflective center and a serpiginous aspect.

Conlusions

The etiology of choroidal macrovessels is still unknown. Although some patients may experience metamorphopsia, most of them remain asymptomatic. Appreciating the described signs in the imaging techniques may favour the diagnosis. In our case no further changes were observed after two years of following.

Financial Disclosure

None