Yiqian Hu, Shiyuan Wang, Yang Dong, Xiuli Zhou, Wenjing Yu and Chenghui Xu
Background: Varix of the vortex vein ampulla is a rare, benign condition which may be occasionally found by fundus examination and sometimes mis-classified as visual threatening retinal choroidal diseases. Auxillary examinations such as ultrasonography, OCT, ICGA, and CDFI may help to make a differential diagnosis.
Methods: Three cases were reviewed. The imaging characteristics of varix of the vortex vein ampulla were discussed.
Results: Three cases of varix of the vortex vein ampulla (2 male, 1 female, 48-67 years-old, unilateral) were found occasionally by ultrasonography. The lesion was overlooked by three-mirror contact lens funduscopy in two cases. By ultrasonography, a dome shaped lesion of around 1.5 mm wide 3 mm height on the posterior equator eye wall with high reflective smooth surface and low internal reflectivity could be found. The lesion decreased under probe pressure. OCT showed that the neuralretinal layer and the retinal pigmental epithelial layer bulged into the vitreous with normal reflectivity and in good continuity. The reflectivity under the RPE layer was lowered. No features suggesting bleeding, exudation, edema, or CNV were found. During venous phase of ICGA, density diversions of filled choroidal vein were seen converging into enlarged vortex vein ampulla in the lesion. The dyeing faded in the late phase with no fluorescein leakage during the whole precess. By CDFI, vein flow signal could be found inside the lesion.
Conclusion: Varix of the vortex vein ampulla could be occasionally found by ultrasonography. Typical imaging features on ultrasonography, OCT, ICGA, and CDFI, especially the dynamic nature under pressure will help diagnosis.