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Choroidal macrovessels: multimodal imaging findings and review of the literature

Abstract:
Background/aimsTo describe clinical and multimodal imaging features in a cohort of choroidal macrovessels.MethodsDemographics and multimodal imaging features of 16 eyes of 13 patients with choroidal macrovessels were reviewed. The multimodal imaging included colour fundus photography, fundus autofluorescence (FAF), spectral domain enhanced depth imaging optical coherence tomography (OCT), en face OCT, OCT-angiography (OCT-A), B-scan ultrasonography (US), fluorescein angiography (FFA) and indocyanine green angiography (ICGA).ResultsThree patients had bilateral involvement. On colour fundus photography, three patterns were evident (a clearly visible orange-red vessel; a track of pigmentary changes; spots of mild pigmentary changes). Vessel orientation was horizontal (11 eyes), oblique (4 eyes) or vertical (1 eye). In 2 eyes, the vessel was extra-macular. OCT in all cases showed a hyporeflective choroidal area with posterior shadowing and elevation of the overlying retina. Subretinal fluid was present in 4 eyes. FAF (12 eyes) was normal (7 eyes) or showed a hypofluorescent/hyperfluorescent track (4 eyes) or linear hyperautofluorescence (1 eye). En-face OCT (2 eyes) revealed the course of the macrovessel at the level of choroid and choriocapillaris. On OCT-A (2 eyes) the vessel had a reflectivity similar to surrounding vessels but larger diameter. B-scan US (8 eyes) showed a nodular hypoechogenic lesion. FFA (5 eyes) showed early focal hyperfluorescence (4 eyes) not increasing in later phases, or was normal (1 eye). ICGA (6 eyes) showed early hyperfluorescence of the vessel.ConclusionsChoroidal macrovessels can mimic other entities, leading to underdiagnosis. Appreciating relevant features on different imaging modalities will aid a correct diagnosis.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bjophthalmol-2020-318095

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Role:
Author
ORCID:
0000-0001-6862-6227
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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0002-4455-2814
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Role:
Author
ORCID:
0000-0003-1254-0832
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Role:
Author
ORCID:
0000-0003-1909-6105
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Role:
Author
ORCID:
0000-0001-8682-4067


Publisher:
BMJ Publishing Group
Journal:
British Journal of Ophthalmology More from this journal
Volume:
106
Issue:
4
Pages:
568-575
Publication date:
2021-01-04
DOI:
EISSN:
1468-2079
ISSN:
0007-1161


Language:
English
Keywords:
Pubs id:
1156559
Local pid:
pubs:1156559
Source identifiers:
W3120314334
Deposit date:
2026-02-12
ARK identifier:
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