Varix of the vortex vein ampulla: a case report and imaging correlation.

Background: We report a case of varix of the vortex vein ampulla (VVVA) in the right eye. VVVA is relatively rare and often presents as a fundus mass-like lesion during clinical examination, making it easily confused with choroidal tumors. This case report aims to improve ophthalmologists' understanding of this rare lesion and provide a reference for clinical diagnosis and management. Case presentation: A 29-year-old male presented with 1 month of decreased vision in the right eye. His best-corrected visual acuity was 20/20. B-scan ultrasonography and optical coherence tomography (OCT) revealed a choroidal space-occupying lesion. Fundus examination identified a deep red elevated mass at the inferotemporal VVVA of the right eye. Further indocyanine green (ICG) angiography confirmed VVVA. The mass became more prominent when the patient gazed downward with the right eye. After applying pressure to the eye, follow-up B-scan and OCT showed the mass had disappeared or reduced-findings that strongly confirmed the lesion was VVVA rather than a choroidal tumor. Conclusion: VVVA is an uncommon condition. This case reminds ophthalmologists to consider less common causes when evaluating choroidal mass-like lesions. Accurate diagnosis of VVVA is critical to avoid misdiagnosis as a choroidal tumor and unnecessary invasive testing or treatment. Recognition of this benign condition can prevent misdiagnosis as a choroidal tumor and unnecessary invasive testing.