Coarsening of choriocapillaris on optical coherence tomography angiography as a sign of acute idiopathic blind spot enlargement

PURPOSE: Acute idiopathic blind spot enlargement is a rare syndrome that is classified within a spectrum of primary inflammatory choriocapillaropathies with circumscribed outer retinal dysfunction. OBSERVATIONS: We observed coarsening of the choriocapillaris on en-face optical coherence tomography angiography when compared to the fellow eye in a patient with suspected acute idiopathic blind spot enlargement. CONCLUSIONS AND IMPORTANCE: Increased granularity of the choriocapillaris as imaged by optical coherence tomography angiography may assist in the diagnosis of acute idiopathic blind spot enlargement, particularly during a global pandemic when access to electrodiagnostics is limited. This finding supports the current evidence of choriocapillaris hypoperfusion in the pathogenesis of acute idiopathic blind spot enlargement.