PT - JOURNAL ARTICLE AU - Beatrice Gallo AU - Samantha R de Silva AU - Omar A Mahroo AU - Zubin Saihan AU - Praveen J Patel AU - Jonathan G Dowler AU - Carlos Pavesio AU - Pearse A Keane AU - Adnan Tufail AU - Mandeep S Sagoo TI - Choroidal macrovessels: multimodal imaging findings and review of the literature AID - 10.1136/bjophthalmol-2020-318095 DP - 2022 Apr 01 TA - British Journal of Ophthalmology PG - 568--575 VI - 106 IP - 4 4099 - http://bjo.bmj.com/content/106/4/568.short 4100 - http://bjo.bmj.com/content/106/4/568.full SO - Br J Ophthalmol2022 Apr 01; 106 AB - Background/aims To describe clinical and multimodal imaging features in a cohort of choroidal macrovessels.Methods Demographics 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).Results Three 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.Conclusions Choroidal macrovessels can mimic other entities, leading to underdiagnosis. Appreciating relevant features on different imaging modalities will aid a correct diagnosis.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information.