Research progress of macular choroidal macrovessel_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhou Sirui , Hu Mingjue ,  Luo Ting

Department of Ophthalmology, The Third People`s Hospital of Chengdu, Ophthalmic Medical Quality Control Center of Chengdu, Chengdu 610000, China;

Corresponding author：

Luo Ting, Email: 305799571@qq.com

Keywords：

Macular choroidal macrovessel; Choroidal vessel; Multimodal imagings; Review

DOI：

10.3760/cma.j.cn511434-20240730-00288

Video：

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Macular choroidal macrovessel (MCM) is a recently reported rare choroidal vascular abnormality, characterized by a distinctly thickened choroidal vessel extending from the macular area to the temporal periphery area in fundus examinations. MCM may be an abnormal dilatation of the posterior ciliary artery. The diagnosis of MCM relies on multimodal imaging examinations, with indocyanine green angiography and optical coherence tomography being particularly critical, while optical coherence tomography angiography serves as an essential supplementary and non-invasive alternative. Due to its rarity, ophthalmologists generally have limited awareness of MCM. In clinical practice, it is essential to be familiar with the clinical manifestations and imaging characteristics of MCM, to improve diagnostic levels, enhance differentiation capabilities, and minimize the occurrence of misdiagnosis.

1.	Lima LH, Laud K, Chang LK, et al. Choroidal macrovessel[J]. Br J Ophthalmol, 2011, 95(9): 1333-1334. DOI: 10.1136/bjo.2009.176800.
2.	Ehlers JP, Rayess H, Spaide RF. Isolated choroidal macrovessel: a tracklike choroidal lesion[J/OL]. Can J Ophthalmol, 2014, 49(6): e158-e160[2014-12-01]. https://pubmed.ncbi.nlm.nih.gov/25433756/. DOI: 10.1016/j.jcjo.2014.09.006.
3.	Pichi F, Nucci P, Srivastava SK. Choroidal macrovessel[J]. Ophthalmology, 2016, 123(3): 531. DOI: 10.1016/j.ophtha.2015.12.036.
4.	Kovach JL. Unilateral choroidal macrovessel[J/OL]. JAMA Ophthalmol, 2016, 134(3): e153678[2016-04-10]. https://pubmed.ncbi.nlm.nih.gov/26967751/. DOI: 10.1001/jamaophthalmol.2015.3678.
5.	Choudhry N, Rao RC. Enhanced depth imaging features of a choroidal macrovessel[J]. Retin Cases Brief Rep, 2016, 10(1): 18-21. DOI: 10.1097/ICB.0000000000000157.
6.	Inoue M, Dansingani KK, Freund KB. Progression of age-related macular degeneration overlying a large choroidal vessel[J]. Retin Cases Brief Rep, 2016, 10(1): 22-25. DOI: 10.1097/ICB.0000000000000177.
7.	Mahroo OA, Puertas RA, Saihan Z. Swept source OCT image of a choroidal macrovessel[J]. Ophthalmol Retina, 2017, 1(4): 281. DOI: 10.1016/j.oret.2016.12.007.
8.	Hampton BM, Kovach JL. Choroidal macrovessel imaged with OCT angiography[J]. Ophthalmol Retina, 2017, 1(6): 562. DOI: 10.1016/j.oret.2017.08.003.
9.	Dalvin LA, Pennington JD, Mashayekhi A, et al. Multimodal imaging of macular choroidal macrovessel: a report of two cases[J]. Retin Cases Brief Rep, 2021, 15(3): 218-223. DOI: 10.1097/ICB.0000000000000776.
10.	Casalino G, De Simone L, Scialdone A, et al. Choroidal macrovessel: optical coherence tomography angiography and imaging features[J]. Indian J Ophthalmol, 2019, 67(7): 1168-1170. DOI: 10.4103/ijo.IJO_2085_18.
11.	Otero-Marquez O, Ledesma-Gil G, Alauddin S, et al. Non-invasive imaging of a choroidal macrovessel[J/OL]. Am J Ophthalmol Case Rep, 2020, 20: 100871[2020-08-12]. https://pubmed.ncbi.nlm.nih.gov/33083631/. DOI: 10.1016/j.ajoc.2020.100871.
12.	Mori H, Yamada H, Sato Y, et al. Optical coherence tomographic angiography and ultra-widefield indocyanine green angiography of a choroidal macrovessel[J/OL]. Am J Ophthalmol Case Rep, 2020, 18: 100612[2020-01-30]. https://pubmed.ncbi.nlm.nih.gov/32083226/. DOI: 10.1016/j.ajoc.2020.100612.
13.	Kataoka K, Kase S, Noda K, et al. Laser speckle flowgraphy findings in a patient with choroidal macrovessel[J]. Ophthalmol Retina, 2020, 4(11): 1123-1124. DOI: 10.1016/j.oret.2020.06.018.
14.	Lima LH, Pimenta R, Zett C. Multimodal imaging of choroidal macrovessel[J]. J Fr Ophtalmol, 2020, 43(4): 371-372. DOI: 10.1016/j.jfo.2019.09.009.
15.	Tapia Quijada HE, Pareja Rios A, Serrano Garcia M, et al. Choroidal macrovessel and persistent metamorphopsia after epiretinal membrane surgery[J]. Arch Soc Esp Oftalmol (Engl Ed), 2022, 97(6): 344-349. DOI: 10.1016/j.oftale.2021.02.008.
16.	Moreira-Neto CA, Lima LH, Zett C, et al. En-face OCT and OCT angiography analysis of macular choroidal macrovessel[J/OL]. Am J Ophthalmol Case Rep, 2021, 21: 101012[2021-01-11]. https://pubmed.ncbi.nlm.nih.gov/33490717/. DOI: 10.1016/j.ajoc.2021.101012.
17.	Mopuru R, Liu TYA, Arevalo JF. Choroidal macrovessel diagnosed on multimodal imaging, including swept-source optical coherence tomography angiography[J]. Case Rep Ophthalmol, 2022, 13(1): 215-219. DOI: 10.1159/000521895.
18.	Fogel-Levin M, Wong A, Sadda SR, et al. Rare case of extramacular choroidal macrovessel[J/OL]. Can J Ophthalmol, 2022, 57(3): e89-e91[2021-10-19]. https://pubmed.ncbi.nlm.nih.gov/34678174/. DOI: 10.1016/j.jcjo.2021.09.011.
19.	Bowen RC, Raval V, Soto H, et al. Choroidal macrovessel: Systematic review and analysis of anatomic origin[J]. Surv Ophthalmol, 2022, 67(2): 570-578. DOI: 10.1016/j.survophthal.2021.07.003.
20.	骆挺, 杨娅丽, 杨俊峰. 黄斑部脉络膜大血管致视物变形1例[J]. 中华眼科杂志, 2023, 59(5): 411-413. DOI: 10.3760/cma.j.cn112142-20221002-00481.Luo T, Yang YL, Yang JF. Metamorphopsia caused by macular choroidal macrovessel: a case report[J]. Chin J Ophthalmol, 2023, 59(5): 411-413. DOI: 10.3760/cma.j.cn112142-20221002-00481.
21.	Gallo B, de Silva SR, Mahroo OA, et al. Choroidal macrovessels: multimodal imaging findings and review of the literature[J]. Br J Ophthalmol, 2022, 106(4): 568-575. DOI: 10.1136/bjophthalmol-2020-318095.
22.	Desmettre T, Paques M. Subfoveal posterior ciliary arteries: Multimodal imaging and classification based on choroidal elevation[J]. J Fr Ophtalmol, 2022, 45(10): 1184-1191. DOI: 10.1016/j.jfo.2022.05.013.
23.	Hayreh SS. Posterior ciliary artery circulation in health and disease: the Weisenfeld lecture[J]. Invest Ophthalmol Vis Sci, 2004, 45(3): 749-757. DOI: 10.1167/iovs.03-0469.
24.	Yang L, Jonas JB, Wei W. Choroidal vessel diameter in central serous chorioretinopathy[J/OL]. Acta Ophthalmol, 2013, 91(5): e358-e362[2013-05-07]. https://pubmed.ncbi.nlm.nih.gov/23647989/. DOI: 10.1111/aos.12059.
25.	Mazzeo T, Leber HM, da Silva AG, et al. Pachychoroid disease spectrum: review article[J]. Graefe's Arch Clin Exp Ophthalmol, 2022, 260(3): 723-735. DOI: 10.1007/s00417-021-05450-3.
26.	Cheung CMG, Lee WK, Koizumi H, et al. Pachychoroid disease[J]. Eye (Lond), 2019, 33(1): 14-33. DOI: 10.1038/s41433-018-0158-4.
27.	Muscat S, Parks S, Kemp E, et al. Secondary retinal changes associated with choroidal naevi and melanomas documented by optical coherence tomography[J]. Br J Ophthalmol, 2004, 88(1): 120-124. DOI: 10.1136/bjo.88.1.120.
28.	Sukkarieh G, Lejoyeux R, LeMer Y, et al. The role of near-infrared reflectance imaging in retinal disease: a systematic review[J]. Surv Ophthalmol, 2023, 68(3): 313-331. DOI: 10.1016/j.survophthal.2022.12.003.
29.	Spaide RF, Fujimoto JG, Waheed NK, et al. Optical coherence tomography angiography[J]. Prog Retin Eye Res, 2018, 64: 1-55. DOI: 10.1016/j.preteyeres.2017.11.003.
30.	Jia Y, Bailey ST, Hwang TS, et al. Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye[J/OL]. Proc Natl Acad Sci USA, 2015, 112(18): E2395-2402[2015-05-05]. https://pubmed.ncbi.nlm.nih.gov/25897021/. DOI: 10.1073/pnas.1500185112.
31.	Babiuch Md AS, Uchida Md Ph DA, Figueiredo Md N, et al. Impact of optical coherence tomography angiography review strategy on detection of choroidal neovascularization[J]. Retina, 2020, 40(4): 672-678. DOI: 10.1097/IAE.0000000000002443.
32.	Lu Y, Zhou H, Zhou X, et al. Correlation between laser speckle flowgraphy and OCT-derived retinal and choroidal metrics in healthy human eye[J]. Transl Vis Sci Technol, 2022, 11(6): 15. DOI: 10.1167/tvst.11.6.15.
33.	Lima LH, Melo GB, Zett C, et al. Optical coherence tomography angiography findings in diffuse unilateral subacute neuroretinitis[J]. Ophthalmic Surg Lasers Imaging Retina, 2020, 51(2): 76-83. DOI: 10.3928/23258160-20200129-02.
34.	Cherukuri N, Panchal B, Kaza H, et al. Role of PASCAL and optical coherence tomography angiograpgy in the treatment of diffuse unilateral subacute neuroretinitis caused by large live motile worm[J]. Indian J Ophthalmol, 2019, 67(9): 1494-1496. DOI: 10.4103/ijo.IJO_177_19.
35.	Sen M, Honavar SG. Circumscribed choroidal hemangioma: an overview of clinical manifestation, diagnosis and management[J]. Indian J Ophthalmol, 2019, 67(12): 1965-1973. DOI: 10.4103/ijo.IJO_2036_19.
36.	He G, Zhang X, Zhuang X, et al. A novel exploration of the choroidal vortex vein system: incidence and characteristics of posterior vortex veins in healthy eyes[J]. Invest Ophthalmol Vis Sci, 2024, 65(2): 21. DOI: 10.1167/iovs.65.2.21.
37.	Adam CR, Sigler EJ, Randolph JC, et al. Submacular choroidal varix simulating chorioretinal folds with metamorphopsia[J]. Ophthalmic Surg Lasers Imaging Retina, 2013, 44(6): 596-598. DOI: 10.3928/23258160-20131024-01.
38.	Ganne P, Krishnappa NC. Congenital retinal macrovessels[J]. Indian J Ophthalmol, 2018, 66(1): 129. DOI: 10.4103/ijo.IJO_475_17.
39.	Nourinia R, Hassanpour K. Congenital retinal macrovessel; optical coherence tomography angiography features[J]. J Ophthalmic Vis Res, 2023, 18(2): 245-248. DOI: 10.18502/jovr.v18i2.13191.

1. Lima LH, Laud K, Chang LK, et al. Choroidal macrovessel[J]. Br J Ophthalmol, 2011, 95(9): 1333-1334. DOI: 10.1136/bjo.2009.176800.
2. Ehlers JP, Rayess H, Spaide RF. Isolated choroidal macrovessel: a tracklike choroidal lesion[J/OL]. Can J Ophthalmol, 2014, 49(6): e158-e160[2014-12-01]. https://pubmed.ncbi.nlm.nih.gov/25433756/. DOI: 10.1016/j.jcjo.2014.09.006.
3. Pichi F, Nucci P, Srivastava SK. Choroidal macrovessel[J]. Ophthalmology, 2016, 123(3): 531. DOI: 10.1016/j.ophtha.2015.12.036.
4. Kovach JL. Unilateral choroidal macrovessel[J/OL]. JAMA Ophthalmol, 2016, 134(3): e153678[2016-04-10]. https://pubmed.ncbi.nlm.nih.gov/26967751/. DOI: 10.1001/jamaophthalmol.2015.3678.
5. Choudhry N, Rao RC. Enhanced depth imaging features of a choroidal macrovessel[J]. Retin Cases Brief Rep, 2016, 10(1): 18-21. DOI: 10.1097/ICB.0000000000000157.
6. Inoue M, Dansingani KK, Freund KB. Progression of age-related macular degeneration overlying a large choroidal vessel[J]. Retin Cases Brief Rep, 2016, 10(1): 22-25. DOI: 10.1097/ICB.0000000000000177.
7. Mahroo OA, Puertas RA, Saihan Z. Swept source OCT image of a choroidal macrovessel[J]. Ophthalmol Retina, 2017, 1(4): 281. DOI: 10.1016/j.oret.2016.12.007.
8. Hampton BM, Kovach JL. Choroidal macrovessel imaged with OCT angiography[J]. Ophthalmol Retina, 2017, 1(6): 562. DOI: 10.1016/j.oret.2017.08.003.
9. Dalvin LA, Pennington JD, Mashayekhi A, et al. Multimodal imaging of macular choroidal macrovessel: a report of two cases[J]. Retin Cases Brief Rep, 2021, 15(3): 218-223. DOI: 10.1097/ICB.0000000000000776.
10. Casalino G, De Simone L, Scialdone A, et al. Choroidal macrovessel: optical coherence tomography angiography and imaging features[J]. Indian J Ophthalmol, 2019, 67(7): 1168-1170. DOI: 10.4103/ijo.IJO_2085_18.
11. Otero-Marquez O, Ledesma-Gil G, Alauddin S, et al. Non-invasive imaging of a choroidal macrovessel[J/OL]. Am J Ophthalmol Case Rep, 2020, 20: 100871[2020-08-12]. https://pubmed.ncbi.nlm.nih.gov/33083631/. DOI: 10.1016/j.ajoc.2020.100871.
12. Mori H, Yamada H, Sato Y, et al. Optical coherence tomographic angiography and ultra-widefield indocyanine green angiography of a choroidal macrovessel[J/OL]. Am J Ophthalmol Case Rep, 2020, 18: 100612[2020-01-30]. https://pubmed.ncbi.nlm.nih.gov/32083226/. DOI: 10.1016/j.ajoc.2020.100612.
13. Kataoka K, Kase S, Noda K, et al. Laser speckle flowgraphy findings in a patient with choroidal macrovessel[J]. Ophthalmol Retina, 2020, 4(11): 1123-1124. DOI: 10.1016/j.oret.2020.06.018.
14. Lima LH, Pimenta R, Zett C. Multimodal imaging of choroidal macrovessel[J]. J Fr Ophtalmol, 2020, 43(4): 371-372. DOI: 10.1016/j.jfo.2019.09.009.
15. Tapia Quijada HE, Pareja Rios A, Serrano Garcia M, et al. Choroidal macrovessel and persistent metamorphopsia after epiretinal membrane surgery[J]. Arch Soc Esp Oftalmol (Engl Ed), 2022, 97(6): 344-349. DOI: 10.1016/j.oftale.2021.02.008.
16. Moreira-Neto CA, Lima LH, Zett C, et al. En-face OCT and OCT angiography analysis of macular choroidal macrovessel[J/OL]. Am J Ophthalmol Case Rep, 2021, 21: 101012[2021-01-11]. https://pubmed.ncbi.nlm.nih.gov/33490717/. DOI: 10.1016/j.ajoc.2021.101012.
17. Mopuru R, Liu TYA, Arevalo JF. Choroidal macrovessel diagnosed on multimodal imaging, including swept-source optical coherence tomography angiography[J]. Case Rep Ophthalmol, 2022, 13(1): 215-219. DOI: 10.1159/000521895.
18. Fogel-Levin M, Wong A, Sadda SR, et al. Rare case of extramacular choroidal macrovessel[J/OL]. Can J Ophthalmol, 2022, 57(3): e89-e91[2021-10-19]. https://pubmed.ncbi.nlm.nih.gov/34678174/. DOI: 10.1016/j.jcjo.2021.09.011.
19. Bowen RC, Raval V, Soto H, et al. Choroidal macrovessel: Systematic review and analysis of anatomic origin[J]. Surv Ophthalmol, 2022, 67(2): 570-578. DOI: 10.1016/j.survophthal.2021.07.003.
20. 骆挺, 杨娅丽, 杨俊峰. 黄斑部脉络膜大血管致视物变形1例[J]. 中华眼科杂志, 2023, 59(5): 411-413. DOI: 10.3760/cma.j.cn112142-20221002-00481.Luo T, Yang YL, Yang JF. Metamorphopsia caused by macular choroidal macrovessel: a case report[J]. Chin J Ophthalmol, 2023, 59(5): 411-413. DOI: 10.3760/cma.j.cn112142-20221002-00481.
21. Gallo B, de Silva SR, Mahroo OA, et al. Choroidal macrovessels: multimodal imaging findings and review of the literature[J]. Br J Ophthalmol, 2022, 106(4): 568-575. DOI: 10.1136/bjophthalmol-2020-318095.
22. Desmettre T, Paques M. Subfoveal posterior ciliary arteries: Multimodal imaging and classification based on choroidal elevation[J]. J Fr Ophtalmol, 2022, 45(10): 1184-1191. DOI: 10.1016/j.jfo.2022.05.013.
23. Hayreh SS. Posterior ciliary artery circulation in health and disease: the Weisenfeld lecture[J]. Invest Ophthalmol Vis Sci, 2004, 45(3): 749-757. DOI: 10.1167/iovs.03-0469.
24. Yang L, Jonas JB, Wei W. Choroidal vessel diameter in central serous chorioretinopathy[J/OL]. Acta Ophthalmol, 2013, 91(5): e358-e362[2013-05-07]. https://pubmed.ncbi.nlm.nih.gov/23647989/. DOI: 10.1111/aos.12059.
25. Mazzeo T, Leber HM, da Silva AG, et al. Pachychoroid disease spectrum: review article[J]. Graefe's Arch Clin Exp Ophthalmol, 2022, 260(3): 723-735. DOI: 10.1007/s00417-021-05450-3.
26. Cheung CMG, Lee WK, Koizumi H, et al. Pachychoroid disease[J]. Eye (Lond), 2019, 33(1): 14-33. DOI: 10.1038/s41433-018-0158-4.
27. Muscat S, Parks S, Kemp E, et al. Secondary retinal changes associated with choroidal naevi and melanomas documented by optical coherence tomography[J]. Br J Ophthalmol, 2004, 88(1): 120-124. DOI: 10.1136/bjo.88.1.120.
28. Sukkarieh G, Lejoyeux R, LeMer Y, et al. The role of near-infrared reflectance imaging in retinal disease: a systematic review[J]. Surv Ophthalmol, 2023, 68(3): 313-331. DOI: 10.1016/j.survophthal.2022.12.003.
29. Spaide RF, Fujimoto JG, Waheed NK, et al. Optical coherence tomography angiography[J]. Prog Retin Eye Res, 2018, 64: 1-55. DOI: 10.1016/j.preteyeres.2017.11.003.
30. Jia Y, Bailey ST, Hwang TS, et al. Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye[J/OL]. Proc Natl Acad Sci USA, 2015, 112(18): E2395-2402[2015-05-05]. https://pubmed.ncbi.nlm.nih.gov/25897021/. DOI: 10.1073/pnas.1500185112.
31. Babiuch Md AS, Uchida Md Ph DA, Figueiredo Md N, et al. Impact of optical coherence tomography angiography review strategy on detection of choroidal neovascularization[J]. Retina, 2020, 40(4): 672-678. DOI: 10.1097/IAE.0000000000002443.
32. Lu Y, Zhou H, Zhou X, et al. Correlation between laser speckle flowgraphy and OCT-derived retinal and choroidal metrics in healthy human eye[J]. Transl Vis Sci Technol, 2022, 11(6): 15. DOI: 10.1167/tvst.11.6.15.
33. Lima LH, Melo GB, Zett C, et al. Optical coherence tomography angiography findings in diffuse unilateral subacute neuroretinitis[J]. Ophthalmic Surg Lasers Imaging Retina, 2020, 51(2): 76-83. DOI: 10.3928/23258160-20200129-02.
34. Cherukuri N, Panchal B, Kaza H, et al. Role of PASCAL and optical coherence tomography angiograpgy in the treatment of diffuse unilateral subacute neuroretinitis caused by large live motile worm[J]. Indian J Ophthalmol, 2019, 67(9): 1494-1496. DOI: 10.4103/ijo.IJO_177_19.
35. Sen M, Honavar SG. Circumscribed choroidal hemangioma: an overview of clinical manifestation, diagnosis and management[J]. Indian J Ophthalmol, 2019, 67(12): 1965-1973. DOI: 10.4103/ijo.IJO_2036_19.
36. He G, Zhang X, Zhuang X, et al. A novel exploration of the choroidal vortex vein system: incidence and characteristics of posterior vortex veins in healthy eyes[J]. Invest Ophthalmol Vis Sci, 2024, 65(2): 21. DOI: 10.1167/iovs.65.2.21.
37. Adam CR, Sigler EJ, Randolph JC, et al. Submacular choroidal varix simulating chorioretinal folds with metamorphopsia[J]. Ophthalmic Surg Lasers Imaging Retina, 2013, 44(6): 596-598. DOI: 10.3928/23258160-20131024-01.
38. Ganne P, Krishnappa NC. Congenital retinal macrovessels[J]. Indian J Ophthalmol, 2018, 66(1): 129. DOI: 10.4103/ijo.IJO_475_17.
39. Nourinia R, Hassanpour K. Congenital retinal macrovessel; optical coherence tomography angiography features[J]. J Ophthalmic Vis Res, 2023, 18(2): 245-248. DOI: 10.18502/jovr.v18i2.13191.

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