Observation of a pulsatile choroidal vascular lesion in a patient with polypoidal choroid vasculopathy during vitrectomy

PURPOSE: To describe a patient in whom a pulsating choroidal vascular lesion was observed during vitrectomy for the treatment of vitreous hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). OBSERVATIONS: A 67-year-old Chinese male was referred to our department for the treatment of vitreous hemorrhage secondary to PCV in his right eye. PCV was confirmed during surgery, accompanied by extensive vitreous and subretinal hemorrhage, and exudation in the posterior pole and temporal to the fovea. A reddish-orange pulsatile lesion was observed at the inferotemporal fundus. The pulsatility of the lesion varied with changes in the intraocular infusion pressure. The pulsating lesion was not visible on fluorescein and indocyanine green angiography performed 1 month after surgery. CONCLUSIONS AND IMPORTANCE: A pulsatile choroidal vascular lesion was observed during vitrectomy. Future studies elucidating the relationships between pulsation, intraocular pressure, and blood flow would help our understanding of the hemodynamics of polypoidal choroidal vessels.