Otero-Marquez Oscar, Ledesma-Gil Gerardo, Alauddin Sharmina, Smith R Theodore
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
Am J Ophthalmol Case Rep. 2020 Aug 12;20:100871. doi: 10.1016/j.ajoc.2020.100871. eCollection 2020 Dec.
To describe novel anatomic findings of an apparent choroidal macrovessel, originally misdiagnosed as a choroidal tumor, using non-invasive imaging tools.
Initial ophthalmic examination revealed an elevated hypopigmented choroidal mass in the macular area, with a serpentine track extending temporally to the equator. Enhanced depth imaging optical coherence tomography (EDI-OCT) revealed an optically hollow lesion just outside the choroid-scleral junction (CSJ), indenting the retina and compressing the choroid from the scleral side. Optical coherence tomography angiography (OCTA) at the choroidal level showed relative low flow within the lesion. En face OCT at the level of the choroid demonstrated similar reflectivity to the physiological adjacent choroidal vessels.
Non-invasive imaging can be used to demonstrate the presence and anatomy of a choroidal macrovessel. OCTA is presented as a useful diagnostic imaging test that can distinguish this lesion from alternative diagnoses without the use of dye injection. In addition to the previously published reports of such vessels in the choroid, we suggest a possible anatomic variant infra-choroidal location of a macrovessel and hypothesize its origin.
使用非侵入性成像工具描述最初被误诊为脉络膜肿瘤的明显脉络膜大血管的新解剖学发现。
初次眼科检查发现黄斑区有一个色素减退的脉络膜肿物隆起，有一条蜿蜒的轨迹向颞侧延伸至赤道。增强深度成像光学相干断层扫描（EDI-OCT）显示在脉络膜-巩膜交界处（CSJ）外侧有一个光学中空病变，使视网膜凹陷并从巩膜侧压迫脉络膜。脉络膜水平的光学相干断层扫描血管造影（OCTA）显示病变内血流相对较低。脉络膜水平的正面OCT显示与相邻生理性脉络膜血管的反射率相似。
非侵入性成像可用于显示脉络膜大血管的存在和解剖结构。OCTA是一种有用的诊断成像检查，无需注射染料即可将此病变与其他诊断区分开来。除了之前发表的关于脉络膜中此类血管的报告外，我们提出了一种可能的大血管脉络膜下位置的解剖变异，并对其起源进行了假设。
