Título / Title

CHOROIDAL MACROVESSEL MULTIMODAL IMAGE

Introdução / Purpose

To report two cases of macular choroidal macrovessel (MCM) with description of multimodal imaging.

Material e Método / Methods

Two female patients were referred for evaluation of a serpiginoid atrophic lesion in the temporal macula. Multimodal imaging, including color fundus photo, indocyanine green angiography (ICGA), and optical coherence tomography (OCT) angiography were done to describe a choroidal macrovessel

Resultados / Results

Fundus examination on the right eye revealed a serpiginoid atrophic lesion in the temporal macula, with a hyperautofluorescence aspect over the lesion. SD-OCT was performed with scans transecting the course of the lesion in the macula. There was hyperreflectivity in the choroid corresponding to the edge of the lesion with associated posterior shadowing.
ICGA showed a large vascular structure with overlying blocking caused by the focal areas of hyperpigmentation. The vessel filled early suggesting it to be arterial. The intensity of the fluorescence paralleled the fluorescence seen in the surrounding, presumably normal choroidal vasculature.
The course and depth of the MCM are highlighted with en face OCT, at the level of choriocapillaris, where it demonstrates a reflectivity similar to physiological choroidal vessels. OCT angiography B-scan showed no decorrelation signal within the vessel.

Discussão e Conclusões / Conclusion

MCM is a rare vascular anomaly that can simulate a parasitic track. To the best of our knowledge this is the first multimodal report, including OCT angiography, of two cases of MCM.

Visualization with EDI-OCT of a large hyporeflective tubular structure in the choroid, with filling characteristics similar to the surrounding choroidal vessels on ICGA established the diagnosis. Using OCT-A, a hyporeflective tubular lesion was seen in the inner choroid. The absence of decorrelation signal within the vessel could be explained by a thicker wall presented by this vessel than normal choroidal vessels.

Palavras Chave

CHOROIDAL MACROVESSEL, OCT-A