PMC4663175_01
(A) Color fundus photograph of the left eye demonstrating a large caliber tortuous choroidal vessel (arrow); choroidal macrovessel. (B) Red filter photograph of the left fundus demonstrating enhanced choroidal detail and choroidal macrovessel traversing the fovea (arrow).
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F1
Visual acuity was normal in both eyes and examination of the posterior segment revealed a large tortuous choroidal vessel involving the fovea with mild overlying RPE changes (Figure 1A). The red channel of the color fundus photograph clearly highlighted this structure (Figure 1B).
(A-C) Enhanced Depth Imaging SD-OCT through the choroidal macrovessel at three points along its course revealed a large caliber choroidal vascular shadow (arrowhead), indenting the RPE proximally and the choroidal-scleral junction distally. The near infrared reflectance images are left of the corresponding EDI-OCT image. Choroidal thickness in (A) was measured to be 431 microns.
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F2
Near infrared reflectance (NIR) showed a subtle hyperreflective serpentine-shaped structure temporal to the fovea (Figure 2, left panels). EDI-OCT revealed a thickened choroid and an enlarged vascular structure that spanned the entire thickness of the choroid, from the choriocapillaris to the choroid-scleral junction (Figure 2). Near the fovea, there was an abnormal ellipsoid zone (EZ), including retinal pigment epithelium (RPE) hyperreflectivity, and focal EZ compression with reduced outer nuclear layer (ONL) thickness, as well as an indented choroidal-scleral junction (CSJ, Figure 2). Transverse EDI-OCT sections of the choroidal macrovessel demonstrated its narrowing as it coursed temporally through the macula (Figure 2).
False-color en face SD-OCT overlayed over near infrared reflectance image of the macula demonstrated the choroidal macrovessel traversing the fovea.
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F3
False-color en face SD-OCT imaging at the level of the choroid was overlayed on the NIR image, which revealed the path of the macrovessel through the temporal macula (Figure 3).