This patient has a retinal venous malformation (formerly known as retinal macrovessel), in addition to full panretinal photocoagulation (PRP) for proliferative diabetic retinopathy. Residual flat disc neovascularization remains despite full PRP.
Learning Points:
A retinal venous malformation is an anomalous retinal vessel that crosses the horizontal raphe (remember that normal retinal vessels respect the horizontal meridian).
These vessels are technically arterio-venous malformations (AVM). Since patients with AVMs can have additional venous anomalies in the brain (24% compared to up to 6% of the population), a brain MRI is recommended to rule out any intracranial abnormalities.
