This 28YO female was referred for an asymptomatic funduscopic finding. Vision was 20/20 OU.
Color imaging shows a superior retinal venous malformation. This vessel drains nearly the entire macula as it extends into the inferotemporal midperiphery. Some mixed foveal drusen are also noted.
Learning Points:
Retinal vessels virtually always respect the horizontal meridian. Retinal venous malformations are congenital anomalous vessels that, by definition, cross the horizontal. Originally described by Gary Brown et al as congenital retinal macrovessels (Arch Ophthalmology 1982;100:1430-1436), these vessels are usually located in the macular region and are virtually always venous.
These lesions are now called retinal venous malformations since about one-quarter of patients will have associated venous anomalies in the brain (Pichi et al JAMA Ophthalmol 2018;136:372-379).
