Color Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography in Diagnosing Polypoidal Choroidal Vasculopathy

Chaikitmongkol, Voraporn; Khunsongkiet, Preeyanuch; Patikulsila, Direk; Ratanasukon, Mansing; Watanachai, Nawat; Jumroendararasame, Chaisiri; Mayerle, Catherine; Han, Ian C.; Chen, Connie J.; Winaikosol, Pawara; Dejkriengkraikul, Chutikarn; Choovuthayakorn, Janejit; Kunavisarut, Paradee; Bressler, Neil M.

doi:10.1016/j.ajo.2018.05.005

Cited by 25 publications

(36 citation statements)

References 16 publications

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“…Other available data show heterogeneity in laterality and location of the involvement. In Asian cohorts, most cases are unilateral (75.9%-97.4%) with a predominantly macular location [21,22,24,29,30,35,40], similar to the pattern observed in Italian [16] and Brazilian [18] cohorts. A study performed jointly in the USA and the UK that included blacks, Caucasians, and Asians also revealed that PCV was mostly unilateral (79% in blacks, 81% in Caucasians, and 79% in Asians) and more frequently located in the macular region (69.4% in blacks, 84.2% in Caucasians, and 78.3% in Asians) [10].…”

Section: Discussionsupporting

confidence: 59%

Polypoidal Choroidal Vasculopathy in Congolese Patients

Kabedi

Kayembe

Elongo

et al. 2020

Journal of Ophthalmology

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Purpose. Polypoidal choroidal vasculopathy (PCV) is a visually debilitating disease that mostly affects people of African and Asian heritage. Indocyanine green angiography (ICGA) is the recommended exploratory method for definitive diagnosis. The disease has been extensively described in Asians and Caucasians, but not in Africans. This study was conducted to document the clinical presentation and optical coherence tomography features of polypoidal choroidal vasculopathy (PCV) in Congolese patients. Methods. A prospective case series of patients with PCV was performed between January 2017 and June 2019. Routine ocular examination was performed including best corrected visual acuity measurement, slit-lamp examination, dilated direct fundoscopy, and spectral domain optical coherence tomography (OCT). The diagnosis was based on a combination of clinical and OCT signs. Results. Fourteen patients were diagnosed with PCV during this period. The average age was 64.7 ± 6.9 years. There were 8 females. Ten (71.4%) patients had systemic hypertension. Most patients (n = 9, 64.3%) had bilateral involvement. Blurred vision was the most common complaint (71.4%). The main clinical presentation was subretinal exudates, seen in 19 (82.6%) eyes of 11 (78.6%) patients and subretinal hemorrhage in 10 (43.5%) eyes. Macular localization was found in 16 eyes (69.5%) of 12 (85.7%) patients. Drusen were observed in 35.7% of the patients. On OCT imaging, thumb-like pigment epithelial detachment and subretinal exudation were the most frequent features, observed in 92.9% and 71.4% of the patients, respectively. Conclusions. PCV in Congolese patients showed features that are more similar to those observed in Caucasians. In this setting where indocyanine green angiography is not available, OCT facilitates the diagnosis of PCV.

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Section: Discussionsupporting

confidence: 59%

Polypoidal Choroidal Vasculopathy in Congolese Patients

Kabedi

Kayembe

Elongo

et al. 2020

Journal of Ophthalmology

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“…On the contrary, Chaikitmongkol et al reported a hybrid diagnostic strategy of noninvasive FP and OCT, and invasive FA. They reported diagnostic criteria with 0.95 sensitivity and 0.95 specificity, which used at least 2 of 4 signs, included hemorrhagic PED on FP, notched PED on OCT, sharply peaked PED (also known as thumb-like PED in the current study) on OCT, and hyperreflective ring (also known as bubble sign in the current study) on OCT [12, 13]. They did not consider potential diagnostic value of other imaging methods as well, although they also chose FP and OCT in their diagnostic criteria, which was same as our diagnostic strategy.…”

Section: Discussionmentioning

confidence: 99%

“…However, ophthalmologists are pretend to get information from complicated examinations of fundus rather than optical coherence tomography angiography (OCT) alone in clinical practice. Chaikitmongkol et al reported multimodal imaging methods to diagnose PCV, in which an invasive imaging method of fluorescent angiography (FA) was used [12, 13]. In clinical practice, ophthalmologists can obtain clues suggesting the diagnosis of PCV using noninvasive imaging methods, including the presence of subretinal orange nodules on fundus photography (FP) and the presence of hyper-reflectivity ring on OCT B-scans and en face OCT.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive multimodal imaging in diagnosing polypoidal choroidal vasculopathy

et al. 2019

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PurposeTo investigate the diagnostic accuracy of noninvasive multimodal imaging methods in diagnosing polypoidal choroidal vasculopathy (PCV) and distinguishing PCV from typical neovascular age-related macular degeneration (nvAMD).MethodsRetrospective study. Imaging features of noninvasive multimodal imaging methods, including fundus photography (FP), B-scan optical coherence tomography (OCT), en face OCT, OCT angiography, and autofluorescence, of 103 eyes with PCV or typical nvAMD were reviewed. Diagnostic strategy was established based on imaging features and was validated in other 105 eyes with PCV or typical nvAMD.ResultsFeatures of subretinal orange nodule on FP, thumb-like PED on OCT, notched PED on OCT, bubble sign on OCT, and Bruch’s membrane depression under serosanguinous PED on OCT were more common. When the diagnostic strategy of using at least 2 of 5 features was performed, there is 0.88 sensitivity and 0.92 specificity for diagnosing PCV. The results of the validation test further confirmed the diagnostic strategy with 0.94 sensitivity and 0.93 specificity.ConclusionsNoninvasive multimodal imaging, especially FP and B-scan OCT, provide high sensitivity and specificity for diagnosing PCV and distinguishing PCV from typical nvAMD, when at least 2 of 5 suggestive imaging features are present.

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“…When a wet AMD is imaged with FA, some features like nodular hyperfluorescence or massive block fluorescence caused by blood might suggest PCV, but these leaking patterns have low specificity because of similar presentation by occult CNV. 2 Optical coherence tomography (OCT) and OCT angiography have been studied recently for diagnosing PCV, but the sensitivity varies from 30% to 83% 3 – 6 because it lacks the capability of displaying temporal leaking information, which is an important diagnostic feature for differentiating subtypes of neovascular AMD. For this reason, OCT is mainly used for assessment of PCV disease activities before the treatment and during the follow-up period.…”

Section: Introductionmentioning

confidence: 99%