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Optical coherence tomographical findings in a case of varix of the vortex vein ampulla
  1. R A Ismail1,
  2. A Sallam2,
  3. H J Zambarakji2
  1. 1The Royal Surrey County Hospital, Surrey, UK
  2. 2Whipps Cross University Hospital, London, UK
  1. Correspondence to R A Ismail, Eye Clinic, The Royal Surrey County Hospital NHS Trust, Egerton Rd, Guildford, GU2 7XX, UK; rehab.ismail{at}yahoo.co.uk

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Case report

A patient was referred to our hospital by the local optometrist with a diagnosis of a subretinal haemorrhage in the right eye after a recent skiing crash. The patient reported repeat falls but no direct trauma to the eye. Our patient was asymptomatic and had no ophthalmic or medical history of note.

On examination, Snellen visual acuity was 6/6 bilaterally. The intraocular pressures were satisfactory in both eyes, and the left fundus was normal. Right fundus examination showed a mildly elevated subretinal lesion in the superonasal peripheral retina (figure 1A). This lesion disappeared with digital pressure on the globe during indirect retinal examination. Indocyanine green angiography showed the dilatation of the vortex vein ampullae that filled early, with a relatively homogeneous filling pattern (figure 1B,C). Optical coherence tomography (OCT) disclosed a large hyporeflective elevated subretinal lesion, which appeared to be of choroidal origin (figure 2A). The lesion flattened significantly when gentle pressure was applied to the globe (figure 2B).

Figure 1

(A) Fundus photography of the right eye showing the gaze-evoked prominence of the vortex vein in extreme superonasal gaze (arrow). (B, C) Indocyanine green angiography …

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