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Ophthalmic Images
October 20, 2021

Prominent Subfoveal Choroidal Vessel Potentially Masquerading as a Nematode

Author Affiliations
  • 1Loma Linda University Eye Institute, Loma Linda, California
  • 2Erie Retinal Surgery, Erie, Pennsylvania
  • 3Retina Consultants of Southern California, Redlands
  • 4Loma Linda University Medical Center, Loma Linda, California
  • 5Veterans Affair Hospital, Loma Linda, California
JAMA Ophthalmol. 2021;139(10):e213410. doi:10.1001/jamaophthalmol.2021.3410

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

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