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. 2022 May 16;260(11):3405–3417. doi: 10.1007/s00417-022-05687-6

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© The Author(s) 2022

Open AccessThis 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 licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence 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 licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 9 — An illustrative case: images of an eye with pachychoroid neovasculopathy in a 53-year-old man. a Color fundus photograph shows a retinal pigment epithelium (RPE) abnormality at the fovea. There is a large choroidal vessel under the fovea. b and c The 12-mm horizontal and vertical B-mode optical coherence tomography (OCT) images through the fovea show pachychoroid with dilated outer choroidal vessels (vortex veins). A shallow irregular RPE detachment accompanied by slight serous retinal detachment is present at the fovea. The central choroidal thickness is 353 µm. d En face OCT image (12 mm × 12 mm) shows dilated vortex veins in the deep layer of the choroid. Superior vortex veins are markedly more evident than the inferior vortex veins. The horizontal watershed zone has disappeared, showing instead collateral veins due to anastomoses between the superior and inferior vortex veins. e OCT angiography (3 mm × 3 mm) shows network vessels corresponding to choroidal neovascularization (CNV) between the detached RPE and Bruch’s membrane. We detected CNV over the dilated vortex veins. f and g Fluorescein angiography (early and late phases) shows window defects and some oozing in the foveal area. h and i Indocyanine green angiography (early and late phases) shows dilated choroidal vessels with hyperpermeability in the macular area, raising suspicion of CNV in the fovea. Reproduced with permission from reference 29