Oh, gather ’round, folks, for a tale of medical mystery and intrigue, featuring a 56-year-old gentleman with multiple myeloma who, in a shocking plot twist, experiences sudden moderate vision loss in his right eye. But fear not, for his vision was still a respectable 20/25. Upon peering into the depths of his eye, doctors discovered a vascular oddity lurking in the perifoveal region, akin to finding a unicorn in your backyard.

Enter the heroes of our story, fluorescein angiography (FA) and optical coherence tomography (OCT), wielding their mighty powers to reveal an isolated perifoveal aneurysmal lesion with minimal leakage and a large oval structure with a hyperreflective wall and exudation. It’s like the eye’s version of a surprise party nobody wanted.

But wait, the plot thickens! Three weeks later, as if by magic, the intraretinal fluid decides to pack its bags and leave without any medical intervention. “Farewell!” it cries, as it vanishes into the night. However, in a dramatic turn of events, the macular edema crashes the party once again three months later, proving it’s the guest that just can’t take a hint.

Our intrepid doctors, scratching their heads, note the resemblance of this aneurysmal lesion to the elusive PEVAC – a perifoveal exudative vascular anomalous complex. For the uninitiated, that’s doctor-speak for “a weird blood vessel thingy in the eye.” PEVAC, the mysterious entity once thought to mingle only among the healthy, has been caught fraternizing with other retinal/choroidal vascular abnormalities and underlying cardiovascular abnormalities. Scandalous!

Thus, our tale concludes with the revelation that even those with multiple myeloma can host a PEVAC party in their eyes. This case not only adds another layer to the enigma that is PEVAC but also serves as a reminder that in the world of medicine, expect the unexpected. And maybe, just maybe, keep an eye out for those vascular oddities. They’re more sociable than we thought.