A patient in their late 60s was found to have a subfoveal hypopigmented tortuous lesion potentially resembling a nematode (Figure, A). Presenting visual acuity was 20/40. Indocyanine green angiography demonstrated hyperfluorescence, confirming the choroidal etiology of the pseudo-nematode pattern (Figure, B). Optical coherence tomography showed an enlarged shallow choroidal vessel causing elevation and mild disruption of the overlying retinal pigment epithelium. Serial imaging did not demonstrate any progression. Though the image appears to resemble the findings of a retinal nematode, a vision-threatening pathology, multimodality imaging confirms a benign anatomical variation.1
Kuriakose RK, Almeida DRP, Chin EK. Prominent Subfoveal Choroidal Vessel Potentially Masquerading as a Nematode. JAMA Ophthalmol. 2021;139(10):e213410. doi:10.1001/jamaophthalmol.2021.3410
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