Optical coherence tomographic angiography and ultra-widefield indocyanine green angiography of a choroidal macrovessel

PURPOSE: We evaluated a choroidal macrovessel using optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA). OBSERVATIONS: A 79-year-old female presented with blurred vision in both eyes and metamorphopsia of the left eye. Mild cataract was noted in both eyes. Color fundus photography of the left eye revealed a red-orange tortuous vessel originating from the fovea and running in an inferior-temporal direction. Enhanced-depth imaging OCT revealed a large caliber choroidal vascular shadow and ambiguous line of the photoreceptor and retinal pigment epithelium layers. OCTA demonstrated a serpentine-shaped choroidal vessel. This anomalous vessel was seen by early phase ICGA as a rapidly perfused vessel connected to a vortex vein. We diagnosed this anomalous vessel as a choroidal macrovessel. We identified that cataract induced blurred vision in both eyes and choroidal macrovessel induced metamorphopsia in left eye. She was received cataract surgery for both eyes. The degree of metamorphopsia and the choroidal macrovessel of the left eye remains unchanged after a year of follow-up. CONCLUSIONS AND IMPORTANCE: OCTA and ICGA are useful techniques to diagnose choroidal macrovessels.