This healthy 13YO female was referred for asymptomatic vascular changes in her right eye. Vision was 20/20 OU.
Optos color RGB imaging shows a prominent superotemporal retinal vein that crosses into the inferotemporal retina. As it descends temporally, it arborizes into numerous smaller branches. There was no leakage angiographically.
Neurologic imaging of our patient was fortunately normal, and observation was recommended.
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 have associated venous anomalies in the brain (Pichi et al, JAMA Ophthalmol, 2018;136:372-379).
