Confirmation of Choroidal Varix Through Divot Sign on Spectral-Domain Optical Coherence Tomography

Enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT) provides a rapid and easily accessible measure to evaluate suspicious choroidal lesions. A 60-year-old woman was referred for evaluation of an inferotemporal slightly pigmented lesion that showed a large hyporeflective elevation in the deep choroid on EDI SD-OCT. After applying pressure to the globe, repeat EDI SD-OCT showed flattening of the lesion with a prominent depression or "divot" within the choroid of the center of the lesion. If noted on imaging, this divot sign is an additional reproducible diagnostic finding that can correctly identify a suspicious choroidal lesion as a benign choroidal varix.