This 88YO female has been followed for a stable untreated branch retinal vein occlusion (BRVO) in her right eye. Vision is 20/50.
Triton color photography shows a few retinal hemorrhages and telangiectatic vessels in the superior macula. A retinal venous macroaneurysm is in the superonasal fovea, which occupies nearly full-thickness retina on swept-source OCT.
Learning Points:
In 1990, Cousins et al reported that RVMs can be an additional finding in occlusive venous disease, always in association with collateral vessels or capillary or arterial macroaneurysms (AJO 1990;109:567-570). These vascular abnormalities are often associated with intraretinal lipid (40%) but are less likely to affect central vision since they are usually outside the macula. They tend to have a higher association with retinal ischemia, thus being at a higher rate for developing retinal neovascularization (32%). Continued observation was recommended for our patient.
The terminology for these lesions, which also include retinal capillary macroaneurysms, large retinal capillary aneurysms, telangiectatic capillaries (TelCaps), and perifoveal exudative vascular anomalous complex (PEVAC), is still in flux (Forte et al, Survey Ophthalmology 2025;70:369-379). In general, the term PEVAC is reserved for idiopathic lesions, while the other terms are used for vascular abnormalities secondary to other disorders, including BRVO and diabetes.
