A 69-year-old man with a history of proliferative diabetic retinopathy in both eyes presented with retinal hemorrhages and a whitish boundary demarcating the arterioles (Figure, A, yellow arrowheads, right eye shown). His visual acuity was 20/400 OU. The right eye received several anti–vascular endothelial growth factor injections. En face widefield swept-source optical coherence tomography angiography (SS-OCTA; 15 × 15 mm) of the total retina showed extensive retinal capillary and arteriolar nonperfusion (Figure, B, yellow segmentation lines). The en face OCTA image revealed a tangled-vessel structure surrounded by retinal capillary and arteriolar nonperfusion (Figure, B, blue box). The “polypoidal-like” lesion served as a retinal arteriovenous anastomosis. Retinal arteriovenous shunts at the arteriovenous crossing and venous loops have been described,^1,2 but the lesion shown here is reminiscent of the tangled-vessel appearance of a polypoidal lesion associated with polypoidal choroidal vasculopathy.^3,4 The B-scan with flow corresponding to the blue line confirms that this tangled-vessel lesion is contained within the retina.

一名 69 岁男性，双眼有增殖性糖尿病视网膜病变病史，表现为视网膜出血和白色小动脉边界（图 A，黄色箭头，右眼所示）。他的视力是 20/400 OU。右眼接受了几次抗血管内皮生长因子注射。整个视网膜的正面宽场扫描源光学相干断层扫描血管造影（SS-OCTA；15 × 15 mm）显示广泛的视网膜毛细血管和小动脉无灌注（图 B，黄色分割线）。正面 OCTA 图像显示了一个被视网膜毛细血管和小动脉非灌注包围的缠结血管结构（图 B，蓝色框）。“息肉样”病变用作视网膜动静脉吻合。^{1 ,2}但此处显示的病变让人想起与息肉状脉络膜血管病相关的息肉状病变的血管缠结外观。^{3 ,4}与蓝线相对应的 B 扫描证实了这种缠结的血管病变包含在视网膜内。