DIAGNOSIS OF VORTEX VARIX USING OPTICAL COHERENCE TOMOGRAPHY AND SCLERAL INDENTATION

We report a case of a vortex vein varix diagnosed with optical coherence tomography under globe compression.

To illustrate the dynamical behavior of a vortex vein varix, optical coherence tomography was performed with and without gentle globe indentation with a cotton swab.

A 51-year-old woman was referred by her optician for an incidental finding of a nonpigmented choroidal mass in the right eye. The patient was asymptomatic with a best-corrected visual acuity of 20/16 in both eyes. On fundoscopy, a prominent smooth pink lesion at the level of the superonasal equatorial retina could be observed in the right eye. Peripheral optical coherence tomography over the area revealed dilated choroidal vessels with an overlying healthy retina. Optical coherence tomography scan was repeated applying gentle globe indentation under which the lesion completely collapsed.

This case illustrates that the diagnosis of a vortex vein varix can be made in clinics using noninvasive tools such as optical coherence tomography. The anatomical localization of the lesion and the pressure-evoked fluctuation of size and shape are important clues which lead to the diagnosis.