VARIX OF A VORTEX VEIN AMPULLA INDUCED BY NODULAR SCLERITIS. Issue Volume 16:Issues 3(2022) (9th January 2020)

• Record Type: Journal Article
• Authors: Cabral, Diogo; Nogueira, Vanda
• Is Part Of: Retinal cases & brief reports. Volume 16:Issues 3(2022)
• Page Start: 325
• Page End: 328
• Publication Date: 2020-01-09
• Subjects: vortex vein ampulla varix -- posterior nodular scleritis -- red-eye syndrome -- choroidal mass lesion; Retina -- Diseases -- Periodicals; Retina -- Periodicals; Retinal Diseases -- Periodicals; Retina -- Case Reports; Retinal Diseases -- Case Reports; 617.7
• DOI: 10.1097/ICB.0000000000000968
• Languages: English
• ISSNs: 1935-1089

Abstract

Abstract : Choroidal mass lesions instigate a puzzling differential diagnosis. We report the association of two rare causes of choroidal mass lesions: nodular scleritis and vortex vein ampulla varix. Multimodal imaging was used to illustrate how venous outflow obstruction can play a role in the origin of vortex vein varix. Abstract : Purpose: To describe a patient with a painful red-eye syndrome and a choroidal mass lesion that was diagnosed after multimodal imaging with a vortex vein ampulla varix induced by a nodular posterior scleritis. Methods: Retrospective case report documented with fluorescein angiography, indocyanine green angiography, b-mode ultrasound, fundus imaging, and swept-source optical coherence tomography. Results: A 24-year-old man presented with a painful red eye and sudden onset blurred vision. Fundus exam disclosed macular choroidal folds and a nonpigmented mass lesion at the inferior equator. Swept-source optical coherence tomography showed enlarged choroidal vessels with fluid in the suprachoroidal space under the central macula and a hyporeflective lobulated choroidal cavity in the inferior temporal retina. Multimodal imaging with contrast dyes showed a dilated vortex vein ampulla with early hyperfluorescence and a complete washout in late acquisitions on indocyanine green. The patient recovered uneventfully after a short-course administration of oral nonsteroidal anti-inflammatory drugs, disclosing irregular scleral nodules on swept-source optical coherence tomography that remained stable over a twelve-month follow-up. Conclusion: This report suggests that nodular posterior scleritis can induce a vortex vein ampulla varix and contributes to a better understanding of the pathophysiology of this entity. We further suggest that in a diagnostic puzzling scenario the inflammatory syndrome should be treated before attempting to perform a chorioretinal biopsy.