Peripapillary Choroidal Neovascularization Type 2 With Pitchfork Sign: A Case Report

This study aimed to report a case of peripapillary choroidal neovascularization (CNV) with a pitchfork sign.

Case Report: 

A young female presented with a progressive and painless visual blurring of the left eye. Ophthalmoscopic findings and results of optical coherence tomography (OCT), OCT angiography (OCTA), and fluorescein angiography (FAG) were evaluated. OCT showed subretinal hyperreflective material adjacent to the optic nerve head with multiple vertical finger-like projections extending into the outer retina (pitchfork sign). OCTA revealed that seafan-shaped high-flow vessels above the retinal pigment epithelium (RPE) were compatible with CNV type 2 with a large feeder vessel completely contiguous with the optic nerve. No evidence of ocular or systemic inflammation was found.

Pitchfork sign can be seen in CNV type 2 in either inflammatory or noninflammatory conditions.