Clinical Features of Polypoidal Choroidal Vasculopathy and Visual Outcomes in the Absence of Classic Choroidal Neovascularization

Abstract

Background/Aims: To report on the clinical features of polypoidal choroidal vasculopathy (PCV) and to delineate visual outcomes in the absence of classic choroidal neovascularization (CNV). Methods: Records were retrospectively reviewed of 233 eyes of 215 patients diagnosed with ‘definite’ PCV using Japanese criteria. Results: Of patients with definite PCV, 72.1% were men and 91.6% had unilateral disease. A history of systemic hypertension was elicited in 18.1% of patients, and blood pressure measurement revealed possible hypertension in 27.4% of patients. At the initial evaluation, 28.3% of eyes had classic CNV as assessed by fluorescein angiography and were treated by photodynamic therapy or other means. Of 112 eyes with active exudation but no classic CNV and no recent decreased vision, best-corrected visual acuity (BCVA) at 3 months improved by ≧0.2 logarithm of the minimum angle of resolution (logMAR) in 17%, was unchanged in 72% and worsened by ≧0.2 logMAR in 11%. In 67 eyes of which 1-year data were available, BCVA improved in 19%, was unchanged in 64% and worsened in 16%. Conclusions: The majority of PCV patients were men, with a high rate of diagnosed or suspected hypertension. More than two thirds of eyes had no evidence of classic CNV, of which 89% had stable or improved vision at 3 months without specific treatment. Of eyes followed for 12 months, 83% had stable or improved vision.

Sensitivity and Specificity of Spectral-Domain Optical Coherence Tomography in Detecting Idiopathic Polypoidal Choroidal Vasculopathy

“…12 However, with the advent of new imaging techniques, such as SD OCT, the diagnostic accuracy of this condition has improved and new histopathologic characteristics have been described by different authors. [5][6][7][8][9][10][11][12][13] Some reports have also shown an association of PCV with other diseases such as sickle cell, 14 central retinal vein occlusion, 15 retinitis pigmentosa, 16 CSCR, 17 and melanocytoma. 18 One of the earliest tomographic signs 6,7 described in patients suspected of PCV has been a steep sharp peaklike elevation of the RPE with underlying moderate reflectivity within the peak.…”

Clinical characteristics of polypoidal choroidal vasculopathy in Chinese patients

“…The original description of PCV at the end of the last century [1,2] has tended to differentiate this kind of disorder from exudative age-related macular degeneration throughout the whole world [8][9][10][11][12][13][14][15][16][17][18][19][20]. However, among the reports from different ethnicities between nationalities, the data on PCV varied remarkably.…”

“…PCV has been reported in patients of African, East Asian, and European origin, and the data from PCV patients varies widely among populations [4,[8][9][10][11][12][13]. To our knowledge, until now, only a small number of Chinese PCV patients (up to 38) were reported in previous studies [8,9,[14][15][16]; therefore, we retrospectively analyzed the data from 204 Chinese patients (246 eyes) in our department with a confirmed diagnosis of PCV and reported the results here.…”

Vitreous haemorrhage in massive hemorrhagic polypoidal choroidal vasculopathy: clinical characteristics and surgical outcomes

“…Several reports and case series describing the diverse clinical spectrum, natural course, and role of various modalities of treatments for exudative PCV have been published in the last three decades [1, 2, 6–9, 11, 12], but there are few reports in the literature on the management of vitreous haemorrhage associated with PCV [6, 8, 9, 13]. Vitreous haemorrhage associated with PCV differs from other manifestations of PCV as these eyes are not amenable to ICG angiography.…”

“…Previously, bilaterality has been reported ranging from 9 to 47 % for exudative PCV [1, 8, 9, 12, 14]. PCV had been originally reported in hypertensive middle aged African women [8, 14–16].…”