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. 2019 Oct 11;9:14689. doi: 10.1038/s41598-019-51268-9

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Images of an eye with pachychoroid neovasculopathy in a 68-year-old man. The refraction in the left eye was +1.50 diopters. Best-corrected visual acuity in the left eye was 0.10 logarithm of the minimum angle of resolution unit. (A) Color fundus photograph shows a retinal pigment epithelium (RPE) abnormality with pachydrusen around the macular area. Markedly dilated vortex veins are seen at the fovea. (B,C) 12 mm horizontal and vertical B-mode OCT images through the fovea show pachychoroid with dilated outer choroidal vessels (vortex veins). Dilated vortex veins are notable under the fovea. A shallow irregular RPE detachment accompanied by serous retinal detachment is observed at the fovea. The central choroidal thickness is 465 µm. (D) En face OCT image (12 mm × 12 mm) showing dilated vortex veins in the deep layer of the choroid. The horizontal watershed zone has disappeared, with anastomoses between the superior and inferior vortex veins instead being observed. The collateral veins at the macula show sinusoid like dilatation. (E) OCT angiography (3 mm × 3 mm) shows network vessels of choroidal neovascularization (CNV) between the detached RPE and Bruch’s membrane. CNV was detected over the dilated vortex veins. (F,G) Fluorescein angiography (early and late phases) shows window defects at the posterior pole of the fundus and some oozing in the macular area. (H,I) Indocyanine green angiography (early and late phases) shows suspected CNV at the fovea, choroidal vascular hyperpermeability and punctate hyperfluorescent spots corresponding to pachydrusen around the macular area.