Ophthalmology Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy.
Eur J Ophthalmol. 2022 Jan;32(1):NP130-NP133. doi: 10.1177/1120672120964033. Epub 2020 Nov 2.
To report on the association between a vortex vein varix and suprachoroidal hemorrhage.
A healthy 60 years-old man with high myopia (-10 diopters) was seen because of sudden paracentral metamorphopsias after emesis. Multimodal imaging included Spectral-Domain Optical Coherence Tomography (SD-OCT), ultrasonography and retinal angiography with fluorescein and indocyanine green. His vision was 20/20 but clinical assessment and imaging procedures evaluations showed a suprachoroidal hemorrhage in the temporal part of the para-macular area. The lesion corresponded to a mild hypo-fluorescence area on fluorescein angiography and to a massive detachment of the inner part of the choroid from the suprachoroidal space on SD-OCT. Indocyanine green angiography disclosed engorgement of a big choroidal vessel in the area of the lesion. An adjacent vortex vein varix was found on SD-OCT. A few weeks later the suprachoroidal hemorrhage resolved spontaneously, whereas the vortex vein varix persisted.
We speculate that vortex vein varixes might represent a risk factor for the occurrence of suprachoroidal hemorrhage in high myopia and that this association may be worth investigating.
In a high myopia suprachoroidal hemorrhage might be secondary to vortex vein varixes.
报告涡静脉瘤与脉络膜下出血之间的关联。
一名 60 岁健康男性,高度近视(-10 屈光度),呕吐后突然出现旁中心性视物变形,前来就诊。多模态成像包括频域光学相干断层扫描(SD-OCT)、超声检查以及视网膜荧光素和吲哚青绿血管造影。他的视力为 20/20,但临床评估和影像学检查显示在旁黄斑区颞侧有脉络膜下出血。病变在荧光素血管造影上对应于轻度低荧光区,在 SD-OCT 上对应于脉络膜内层与脉络膜下腔的大量分离。吲哚青绿血管造影显示病变区域的一条大脉络膜血管充血。在 SD-OCT 上发现了一个相邻的涡静脉瘤。几周后,脉络膜下出血自发消退,而涡静脉瘤持续存在。
我们推测涡静脉瘤可能是高度近视患者脉络膜下出血的危险因素,这种关联值得进一步研究。
在高度近视患者中,脉络膜下出血可能继发于涡静脉瘤。