VARIX OF THE VORTEX VEIN AS A DIFFERENTIA L-DIAGNOSIS IN TUMORS OF THE CHOROID

A raised fundus lesion at the level of the choroid has a high potentia l of being malignant since choroidal melanoma can appear clinically in many disguises, Final diagnosis may be made only after thorough inves tigations with ancillary techniques. We report on a case where - using fluorescein angiography - a suspected choroidal melanoma was diagnose d as having been simulated by a varix of a superior vortex vein ampull a. Patient A 51-year-old woman was referred with the diagnosis of a ch oroidal melanoma in the upper periphery of the left fundus. Biomicrosc opical retinal examination of the left eye revealed at upgaze a raised , slightly darkish lesion at the choroidal level in the peripheral 12 o'clock position. The lesion could not be visualised using the 3-mirro r Goldmann contact lens and the area in question appeared fiat. Fluore scein angiography show ed evident dilatation of the superior vortex ve in ampulla at upgaze giving rise to an elevation of both choroid and r etina, Conclusion Dilatation of the vortex vein amypulla is a rarely e ncountered lesion and is most often an incidental finding. Enlargement at up- or downgaze is thought to be evoked by kinking of the vein aft er leaving the eve through a long intrascleral passage in a very obtus e angle, This explains why the lesion could not be seen using the 3-mi rror lens where the globe stays in the primary position, No treatment is indicated.