Retinal pigment epithelium atrophy secondary to dilated choroidal artery in the macula of a highly myopic patient

Indocyanine green angiography revealed a markedly bent and tortuous choroidal artery in the macula of the left fundus in a highly myopic patient. The patient's corrected visual acuity was 1.0 in both eyes, and he had no visual symptoms. Ten years after the initial examination, atrophy of the retinal pigment epithelium (RPE) developed above the dilated choroidal artery. Optical coherence tomography demonstrated that the RPE was stretched above the markedly dilated choroidal artery. Thus, mechanical stretching of the RPE by an abnormally dilated choroidal artery might underlie the development of RPE atrophy.