Abstract:  Objective To observe the clinical characteristics and multimodal imaging characteristics of perifoveal exudative vascular anomalous complex (PEVAC). Design Retrospective case series. Participants 14 patients (14 eyes) with PEVAC in Beijing Tongren Eye Center during January 2011 to June 2022 were included. Methods The medical records data of all patients were reviewed. Main Outcome Measures The characteristics of color fundus image, FFA and OCTA; the blood flow density in different sections including whole image, fovea, parafovea, perifovea and 2 mm diameter. Results 14 patients (14 eyes) with PEVAC lesion included 9 females, with an average age of (63.21±6.69) years. There were 2 cases with diabetes and 4 cases with hypertension. On the color image, small red spots beside the fovea of the macula were seen in 7 cases, yellow white hard exudation changes were seen in 9 cases. FFA and ICGA showed punctate high fluorescence lesion with an average of (1.47±0.74); among them, 18 lesions were located at the temporal side of fovea and 4 lesions were at nasal side. The average distance from fovea to lesion was (690.68±168.68) μm. OCTA was performed in 8 cases. Blood flow signals were detected in the superficial retinal vascular layer in 1 case and in the deep retinal vascular layer in 7 cases. The blood flow density in different section of the superficial and deep layers was not statistically significant between the affected eye and the healthy eye (all P>0.05). Conclusion PEVAC often occurs in the elderly. It is manifested as a single or multiple large aneurysmal abnormality located in the inner layer of the retina that often occur in the temporal side of parafovea. It is often accompanied by exudative changes and rarely accompanied by bleeding. Abnormal blood flow signals can be detected in the deep or superficial retinal vascular layer. (Ophthalmol CHN, 2023, 32: 49-54)

Key words: perifoveal exudative vascular anomalous complex (PEVAC), multimodal imaging