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   Table of Contents      
OPHTHALMIC IMAGE
Year : 2018  |  Volume : 66  |  Issue : 12  |  Page : 1860-1861

Congenital retinal macrovessel in a patient with rhegmatogenous retinal detachment


1 Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
2 ICARE Eye Hospital and Post Graduate Institute, Noida, Uttar Pradesh, India

Date of Web Publication19-Nov-2018

Correspondence Address:
Dr. Vinod Kumar
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_838_18

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How to cite this article:
Kumar V, Goel N. Congenital retinal macrovessel in a patient with rhegmatogenous retinal detachment. Indian J Ophthalmol 2018;66:1860-1

How to cite this URL:
Kumar V, Goel N. Congenital retinal macrovessel in a patient with rhegmatogenous retinal detachment. Indian J Ophthalmol [serial online] 2018 [cited 2019 May 20];66:1860-1. Available from: http://www.ijo.in/text.asp?2018/66/12/1860/245642



A 48-year-old female presented with old inferior rhegmatogenous retinal detachment (RRD) with demarcation line encroaching the macula [Figure 1]a. Best corrected visual acuity was 20/30. Lattice degeneration with atrophic holes was noted at 6'o clock meridian. A branch of the infero-temporal retinal vein coursed upwards through the fovea and crossed the horizontal raphe. Fundus fluorescein angiogram [FFA, [Figure 1]b] confirmed this vessel to be of venous origin and showed absence of foveal avascular zone. Old RRD leading to retinal pigment epithelium (RPE) atrophy showed as hyper fluorescent area while blocked fluorescence was seen in relation to the demarcation line because of RPE hypertrophy. Vertical spectral domain optical coherence tomography scan [Figure 1]c through macula showed inferior subretinal fluid. The vessel passing through the macula was seen in inner retinal layers with shadowing underneath [blue arrow, [Figure 1]c]. The patient was diagnosed with congenital retinal macrovessel (CRM) and inferior RRD. The patient underwent uneventful scleral buckling surgery. Visually acuity was maintained at 20/30 and retina was attached at 6-month follow-up.
Figure 1: Colour fundus photograph (a) showing inferior rhegmatogenous retinal detachment with demarcation line. A branch of the infero-temporal vein passes through the fovea. Fluorescein angiogram (b) shows demarcation line and confirms venous origin of congenital retinal macrovessel. Vertical spectral domain optical coherence tomography scan (c) shows congenital retinal macrovessel (blue arrow) and inferior subretinal fluid

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CRM is rare congenital anomaly and consists of aberrant branch of a retinal vessel crossing the macula and horizontal raphe.[1] Commonly, CRM is a vein, but it may arise from an artery as well and is uusually asymptomatic.[1] Visual loss in patients with CRM has been attributed to serous detachment,[2] macro aneurysm,[3] branch retinal artery occlusion,[4] macular haemorrhage, vitreous haemorrhage,[5] foveal cyst, or mere presence of blood vessel.[1] FFA in CRM usually reveals early filling and delayed emptying and may be associated with dilated capillary bed surrounding the vessels.[6] CRM has never been reported in patient with RRD. The association of the two appears to be coincidental though.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
de Crecchio G, Alfieri MC, Cennamo G, Forte R. Congenital macular macrovessels. Graefes Arch Clin Exp Ophthalmol 2006;244:1183-7.  Back to cited text no. 1
    
2.
Kumar V, Ghosh B, Raina U, Goel N. Central serous chorioretinopathy (CSCR) in a patient with congenital retinal macrovessel. Can J Ophthalmol 2009;44:e57.  Back to cited text no. 2
    
3.
Goel N, Kumar V, Seth A, Ghosh B. Intravitreal bevacizumab in congenital retinal macrovessel with retinal arteriolar macroaneurysm. Saudi J Ophthalmol 2015;29:292-4.  Back to cited text no. 3
    
4.
Goel N, Kumar V, Seth A, Ghosh B. Branch retinal artery occlusion associated with congenital retinal macrovessel. Oman J Ophthalmol 2014;7:96-7.  Back to cited text no. 4
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5.
Goel N, Kumar V, Ghosh B. Congenital retinal macrovessel associated with vitreous hemorrhage. J AAPOS 2017;21:83-5.  Back to cited text no. 5
    
6.
Brown GC, Donoso LA, Magargal LE, Goldberg RE, Sarin LK. Congenital retinal macrovessels. Arch Ophthalmol 1982;100:1430-6.  Back to cited text no. 6
    


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