Doheny Eye Institute, Los Angeles, California.
Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Retin Cases Brief Rep. 2022 Nov 1;16(6):670-673. doi: 10.1097/ICB.0000000000001138.
To describe the multimodal imaging findings of extensive choroidal caverns within a choroidal nevus in an eye with pachychoroid spectrum disease.
A 69-year-old woman was referred with a known history of branch retinal vein occlusion in the right eye and choroidal nevus in the left eye. Fundus examination of both eyes revealed subretinal yellow deposits, suggestive of pachydrusen. Retinal venous collaterals were noted in the temporal macular of the right eye. A lightly pigmented choroidal lesion with nearly confluent overlying drusen and retinal pigment epithelial alterations, consistent with chronic choroidal nevus, was noted in the macula of the left eye.
Optical coherence tomography B-scans revealed thickened choroid (pachychoroid) with subfoveal choroidal thickness of 504 µ m and 580 µ m with large hyporeflective spaces suggestive of pachyvessels in both eyes. In the region of the choroidal nevus, the choroidal vascular spaces appeared comparatively large and were classified as "caverns" measuring up to 480 µ m in diameter. Optical coherence tomography angiography and indocyanine green angiography demonstrated the absence of flow within the caverns. Indocyanine green angiography further illustrated choroidal vascular hyperpermeability with patchy hyperfluorescent areas in both eyes. Wide-field swept-source optical coherence tomography showed mild posterior scleral bowing, a feature occasionally documented with choroidal nevus, and highlighted greater hyporeflectivity and hypertransmission on optical coherence tomography within the caverns compared with the noncavernous choroidal vessels.
Choroidal caverns can occur within choroidal nevus in the setting of pachychoroid disease.
描述在患有厚脉络膜谱系疾病的眼中，脉络膜痣内广泛的脉络膜腔的多模态成像表现。
一位 69 岁女性因右眼分支视网膜静脉阻塞和左眼脉络膜痣而被转诊。双眼眼底检查显示视网膜下黄色沉积物，提示厚脉络膜沉积物。右眼颞侧黄斑可见视网膜静脉侧支。左眼黄斑可见轻度色素沉着的脉络膜病变，几乎伴有融合的上方沉积物和视网膜色素上皮改变，符合慢性脉络膜痣。
光学相干断层扫描 B 型扫描显示双眼均存在增厚的脉络膜（厚脉络膜），下脉络膜厚度为 504µm 和 580µm，并有大的低反射空间，提示存在厚血管。在脉络膜痣区域，脉络膜血管空间相对较大，被分类为直径达 480µm 的“腔”。光学相干断层扫描血管造影和吲哚青绿血管造影显示腔内无血流。吲哚青绿血管造影进一步显示双眼脉络膜血管通透性增加，出现斑片状高荧光区。宽视野扫频源光学相干断层扫描显示轻度后巩膜弓，这是脉络膜痣偶尔出现的特征，并突出显示腔内的光学相干断层扫描信号较非腔性脉络膜血管的信号更低反射和更高传输。
在厚脉络膜疾病的情况下，脉络膜腔可发生在脉络膜痣内。
