Multimodal imaging in perifoveal exudative vascular anomalous complex with co-existent diabetic retinopathy

摘要： Perifoveal exudative vascular anomalous complex (PEVAC) is a recently described macular entity, which can be overlooked or confused with other retinal pathologies. On the basis of multimodal imaging features of 15 eyes with PEVAC, Sacconi et al.1 defined a PEVAC lesion as a unilateral, isolated, perifoveal, aneurysmal abnormality, occurring in otherwise healthy individuals, having characteristic angiographic and tomographic features and typically resistant to anti-vascular endothelial growth factor (anti-VEGF) therapy. Clinically, a PEVAC lesion is associated with intra-retinal fluid, haemorrhage and/or hard exudates. Querques et al.2 reported two cases of PEVAC and described the related angiographic and optical coherence tomography (OCT) features. In particular, there were no features of arterial hypertension, diabetes, or any other systemic or local vasculopathy, or signs of age-related macular degeneration. Multimodal imaging, in particular OCT-angiography along with OCT, fluorescein angiography and indocyanine angiography, have been used to provide a better understanding of the pathophysiological mechanisms of PEVAC. The purpose of this case report is to describe the imaging findings of a PEVAC lesion in a patient who had features of diabetic retinopathy.