Macular vortex vein in high myopia.

Fundus examination in a 25-year-old myopic man with a refractive error of -10DS, -1.50 DC × 10°, 6/9, N6 in both eyes showed normal retinal periphery, tilted optic disc with peripapillary atrophy and dilated submacular vasculature in the RE. [Fig. 1a] Sequential indocyanine green angiography images showed the filling and emptying of the dye in a macular vortex vein in the RE (white arrow) [Fig. 1b and c]. The ampulla of the vortex vein was seen nasal to the fovea. Spectral-domain optical coherence tomography demonstrated dilated choroidal vessels at the posterior pole (yellow arrow) [Fig. 1d].

Figure 1

Posterior vortex vein in high myopia

Posterior vortex veins (PVV) may be a prominent incidental finding seen in nearly one-quarter of highly myopic eyes. PVV is usually found exiting the eye either at the margin of the optic nerve head or at the macula on indocyanine green angiography.[12] Eyes with PVV have reduced axial length, posterior staphyloma, and higher incidence of choroidal neovascularization-related macular atrophy.[23] The imaging modality routinely used to identify PVV is ultrawide indocyanine green angiography and more recently optical coherence tomography angiography.[24]

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