Aims To describe the clinical features, multimodal imaging, treatments and natural course of acute spontaneous vortex vein occlusion. Methods Clinical data were collected on nine patients with acute vortex vein occlusion. The symptoms and signs, multimodal imaging, treatments and follow-up results were summarised. Results Six patients (66.7%) were men and three (33.3%) were women. The mean age was 47.8±15.4 years. Patients were initially misdiagnosed as having choroidal tumour (66.7%), scleritis (22.2%) and peripheral exudative haemorrhagic chorioretinopathy (11.1%). The related clinical characteristics included choroidal pseudo-tumour (100%), anterior segment injection (88.9%), acute ocular pain (77.8%), transient blurred vision (66.7%) and subsequent scleral icterus (66.7%). Six patients (66.7%) experienced a definite Valsalva manoeuvre prior to the onset. In acute phase, ultrasonography showed a low-to-medium reflective lesion without inside blood flow signal (mean thickness, 2.7±0.6 mm). Swept-source optical coherence tomography angiography (SS-OCTA) demonstrated the dilated vortex veins and ampulla with suprachoroidal haemorrhage and exudation. Indocyanine green angiography (ICGA) demonstrated choroidal circulation abnormalities in the affected quadrant. MRI showed a well-defined mass with enhancement. The main treatment was medical observation (44.5%). The choroidal pseudo-tumour spontaneously resolved with a mean course of 4.1±1.9 weeks. Conclusions Acute vortex vein occlusion is a rare condition and initial misdiagnosis is not uncommon. It is mainly identified as an evanescent choroidal pseudo-tumour with acute pain, red eye and blurred vision. Widefield ICGA and SS-OCTA can offer valuable diagnostic clues. Medical observation may be a treatment option. All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

中文翻译：

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急性自发性涡旋静脉阻塞：临床特征、多模式影像学检查和自然病程


目的 描述急性自发性涡旋静脉闭塞的临床特征、多模态影像学检查、治疗和自然病程。方法 收集 9 例急性涡流静脉闭塞患者的临床资料。总结了症状和体征、多模式成像、治疗和随访结果。结果 6 例患者 （66.7%） 为男性，3 例 （33.3%） 为女性。平均年龄为 47.8±15.4 岁。患者最初被误诊为脉络膜瘤 （66.7%） 、巩膜炎 （22.2%） 和外周渗出性出血性脉络膜视网膜病变 （11.1%）。相关临床特征包括脉络膜假瘤 （100%）、眼前节注射 （88.9%）、急性眼痛 （77.8%）、短暂性视力模糊 （66.7%） 和随后的巩膜黄疸 （66.7%）。6 例患者 （66.7%） 在发病前经历了明确的 Valsalva 动作。在急性期，超声检查显示低到中度反射病灶，无内部血流信号 （平均厚度，2.7±0.6 mm）。扫描源光学相干断层扫描血管造影 （SS-OCTA） 显示涡静脉和壶腹扩张，伴有脉络膜上出血和渗出。吲哚菁绿血管造影 （ICGA） 显示受影响象限的脉络膜循环异常。MRI 显示一个边界清晰的肿块，伴有增强。主要治疗方法是医学观察 （44.5%）。脉络膜假瘤自发消退，平均病程为 4.1±1.9 周。结论 急性涡旋静脉阻塞是一种罕见的疾病，初始误诊并不少见。它主要被确定为一种短暂的脉络膜假性肿瘤，伴有急性疼痛、红眼和视力模糊。宽场 ICGA 和 SS-OCTA 可以提供有价值的诊断线索。医学观察可能是一种治疗选择。 与研究相关的所有数据都包含在文章中或作为补充信息上传。不適用。