Idiopathic Polypoidal Choroidal vasculopathy (PCV) is characterized by subretinal vascular lesions leading to multiple, recurrent serosanguinous or hemorrhagic retinal pigment epithelial detachment. The classical PCV occurrence was initially reported in Asian descendent hypertensive middle aged women. Although anti-vascular endothelial growth factor (VEGF) is commonly used as first line treatment in Western countries, photodynamic therapy is the mainstay therapy for PCV in Asia. Here we describe a case of IPCV in a Malay lady who did not respond to initial anti-VEGF monotherapy and subsequently achieved stabilization of the disease with PDT. However, her functional vision was not able to be restored despite the anatomical improvement.

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We describe a case of idiopathic hypertrophic spinal pachymeningitis in a 62-year-old gentleman presenting with progressive myelopathy of two years. The imaging and corresponding histological findings are discussed and correlated.