Overview
Perifoveal exudative vascular anomalous complex (PEVAC) is an isolated aneurysm of the perifoveal retinal vasculature that is of unknown cause and not associated with any retinal vascular or inflammatory disease.
Clinically PEVAC presents with small retinal haemorrhages with associated intraretinal exudation and sometimes hard exudates.
OCT imaging through a PEVAC shows it to be a round intraretinal lesion that is hyper-reflective but with a dark lumen containing material of variable reflectivity. Hypo-reflective cystic spaces (intraretinal fluid) is often associated with these lesions. PEVAC is typically located between the outer plexiform layer and inner nuclear layer.
OCTA shows rarefaction of the retinal capillaries in the area of the PEVAC lesion.
Differential Diagnosis
References
Fernández-Vigo, JI. Burgos-Blasco, B. Dolz-Marco, R. Jiménez-Santos, M. López-Guajardo, L. Donate-López, J. (2020) Atypical perifoveal exudative vascular anomalous complex (PEVAC) with multifocal and bilateral presentation, American Journal of Ophthalmology Case Reports, Volume 18.
Sacconi, R. Bailey Freund, K. Yannuzzi, LA. Dolz-Marco, R. Souied, E. Capuano, V. Semoun, O. Phasukkijwatana, N. Sarraf, D. Carnevali, A. Querques, L. Bandello, F. Querques, G. (2017) The Expanded Spectrum of Perifoveal Exudative Vascular Anomalous Complex. American Journal of Ophthalmology, Volume 184, pp137-146.