Research

Three-dimensional OCT Angiography Visualization of Vortex Vein Varix

AAO Journal1d ago1 min read

A 70-year-old woman with high myopia was referred for evaluation of a suspected choroidal mass in her left eye. The axial length of the left eye was 27.10 mm. Fundus photography showed a tessellated fundus without abnormal findings in the peripheral retina (A). Ultra-widefield OCT and angiography (BMizar, TowardPi Medical Technology Group Co, Ltd) of the superotemporal vortex vein demonstrated elevation of the overlying retina corresponding to a vortex vein varix (B, arrow), with localized thickening on the choroidal thickness map (C).

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AI Summary

Quick Take

A 70-year-old patient with high myopia and a suspected choroidal mass was diagnosed with a vortex vein varix using advanced ultra-widefield OCT and angiography. The imaging revealed localized choroidal thickening and retinal elevation corresponding to the varix, effectively ruling out more serious intraocular malignancies.

Why It Matters

Vortex vein varices are benign vascular anomalies that frequently mimic choroidal melanomas or metastases, leading to diagnostic uncertainty and patient anxiety. This case highlights how ultra-widefield OCTA technology can provide definitive, non-invasive visualization of peripheral vascular structures that were previously difficult to image. For clinicians, accurately identifying these lesions in highly myopic eyes is essential to avoid unnecessary invasive procedures or misdiagnosis of a stable condition.

Key Findings

The patient presented with high myopia and an axial length of 27.10 mm in the affected left eye.
Ultra-widefield OCT and angiography (TowardPi BMizar system) identified the lesion as a superotemporal vortex vein varix.
Imaging demonstrated distinct elevation of the overlying retina directly corresponding to the vascular anomaly.
The choroidal thickness map confirmed localized thickening at the site of the varix, providing a clear anatomical signature of the condition.
Fundus photography initially showed only a tessellated fundus, illustrating the limitations of standard photography in detecting these peripheral elevations.

Practice Implications

When evaluating peripheral choroidal elevations in myopic patients, clinicians should include vortex vein varix in the differential diagnosis. Utilizing ultra-widefield OCTA can confirm the vascular nature of the 'mass' and may reduce the need for more invasive diagnostic pathways or frequent monitoring for suspected malignancy.

Who's Affected

Retina SpecialistsComprehensive OphthalmologistsOptometrists

Evidence StrengthPreliminary

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