Simultaneous Occurrence of Retinal and Choroidal Macrovessels in Two Individual Patients: Case Reports

Purpose:We report two individual rare cases of the simultaneous occurrence of retinal and choroidal macrovessels.Case summary: The first case involved a 39-year-old male who presented with a two-week history of metamorphopsia in his right eye.At the initial visit, visual acuity was 1.0 in both eyes.A choroidal macrovessel transversing the macula was observed in the right eye, and a vascular loop in the inferior retinal arcade and a retinal macrovessel crossing the macula were identified in the left eye.Optical coherence tomography (OCT) revealed bilateral pachyvessels and subretinal fluid in the right macula, which persisted after two months.The second case involved a 36-year-old male with a six-month history of decreased vision in his left eye.At the initial visit, visual acuity was 0.1 in the right eye and 1.0 in the left eye.Subretinal fluid and retinal macrovessel were observed in the left macula.Two months later, the subretinal fluid resolved spontaneously.At a seven-year follow-up, OCT demonstrated pachyvessels in both eyes.Conclusions: Although retinal and choroidal macrovessels originated from distinct embryologic vascular systems and are unlikely to share a direct developmental pathway, both cases showed bilateral pachyvessels.Dysregulation of vascular signaling factors such as vascular endothelial growth factor and angiopoietin, which are involved in both retinal and choroidal vascular development, may contribute to the formation of these abnormal macrovessel structures.