Parafoveal exudative vascular anomalous complex(PEVAC)refers to a large, isolated aneurysmal lesion in the superficial or deep capillary plexus of the parafoveal retina demonstrated by optical coherence tomography(OCT)imaging and has been identified as a new entity. Patients are almost middle-aged and elder people, not accompanied by retinal vascular diseases, but can develop with myopic or age-related macular degeneration(ARMD). It has been defined as PEVAC-resembling lesions when associated with retinal vascular diseases, such as diabetic retinopathy(DR)or retinal vein occlusion. It is non-exudative in the early stage, but later intraretinal exudation may induce metamorphopsia or visual decline. In some cases, the lesion was unchanged or spontaneously resolved during long-term follow-up.Differentiation from type 3 retinal neovascularization(retinal angiomatous proliferation, RAP)and Type I MacTel may be required. The anti-vascular endothelial growth factor(VEGF)therapy is ineffective and micropulse laser treatment could achieve improvement in a few cases. It is speculated that the lesion is associated with degeneration of retinal microvascular pericytes.