Varicosity of Vortex Vein Ampulla in Ocular Fundus: Descriptive Series of 53 Patients and Literature Review

Background/Objectives: Varicosities of the vortex vein ampulla are transient dilations of vortex vein ampullae that appear as red-brown choroidal masses. The purpose of this manuscript is to describe a retrospective case series of 53 patients with varicosities of the vortex vein ampulla and perform a literature review on this topic. Methods: Our case series demonstrates the clinical features of a large cohort of varicosities of the vortex vein ampulla, including their locations in the ocular fundus, sizes when congested, direction of gaze that resulted in detection, frequency of multiple lesions in a single eye, and frequency of bilateral cases. The literature review utilized PubMed and Embase libraries and included all studies published through December 2025. Results: The literature review yielded 44 articles, of which 36 were deemed relevant. Several studies described the appearance of these lesions using imaging modalities, including B-scan ultrasonography, optical coherence tomography, and indocyanine green angiography. Others underscored the potential for these lesions to be mistaken for other types of choroidal masses, such as choroidal melanomas. Conclusions: This extensive series demonstrates that these lesions are most often located nasally, sometimes multiple or bilateral, and often mistaken for choroidal nevi or melanomas, highlighting the importance of understanding clinical characteristics for appropriate diagnosis. In addition, some studies described possible associations with conditions such as nodular scleritis and Donnai-Barrow syndrome.