Haemorrhagic pigment epithelial detachment as a predictive feature of polypoidal choroidal vasculopathy in a Chinese population

Abstract

Purpose To determine the frequency of haemorrhagic pigment epithelial detachment (PED) among patients presenting with either polypoidal choroidal vasculopathy (PCV) or choroidal neovascularization (CNV) and calculate the degree to which the presence of a haemorrhagic PED can be used to predict the diagnosis of PCV. Methods A retrospective review of 290 eyes of 253 patients presenting to the Singapore National Eye Centre with serosanguineous maculopathy. Patients underwent ophthalmologic examination including digital colour fundus photography and stereoscopic fluorescein angiography and indocyanine green angiography (ICGA). Classification into PCV or CNV was based on ICGA findings, and presence or absence of haemorrhagic PED was documented. Results In total, 138 eyes of 123 patients were diagnosed with PCV and 152 eyes of 130 patients with CNV. A haemorrhagic PED was a significantly more common (Po0.001) presenting feature in PCV eyes (63, 45.7%) than CNV eyes (6, 3.9%) (odds ratio (OR) 20.4, 95% confidence interval (CI) 8.5-49.4). Age-related maculopathy was found significantly more frequently (Po0.001) in the unaffected fellow eye of CNV patients (57, 52.8%) than PCV patients (28, 22.8%) (OR 3.2, 95% CI 1.8-5.7). Conclusions In patients of Chinese ethnicity, a haemorrhagic PED is significantly more likely to be the presenting feature of PCV than CNV. Patients presenting with this clinical feature should make the clinician suspicious of an underlying diagnosis of PCV.

Polypoidal Choroidal Vasculopathy

“…PCV is a common cause of recurrent hemorrhagic and exudative PEDs in both Caucasian and Asian patients. 3,9,10,25,27,34,38,49,97,105,149 In one prospective study, 34 of 40 (85%) eyes with hemorrhagic and exudative PEDs without evidence of AMD were diagnosed with PCV by ICGA. 31 A review of hemorrhagic PEDs in a Chinese population also concluded that this clinical presentation carries a high index of suspicion for PCV.…”

“…31 A review of hemorrhagic PEDs in a Chinese population also concluded that this clinical presentation carries a high index of suspicion for PCV. 34 Tsujikawa et al 148 reported that of 51 of 93 (55%) eyes with PCV examined had PED: 27 of these were characterized by a notch (53%), and the notch corresponded with the vascular polyps identified by ICGA in 23 (45%) eyes.…”

Six-month visual prognosis in eyes with submacular hemorrhage secondary to age-related macular degeneration or polypoidal choroidal vasculopathy

“…[1][2][3] Such hemorrhagic presentation, including hemorrhagic pigment epithelial detachment, has been described to occur more frequently in the context of polypoidal choroidal vasculopathy (PCV), a condition more common in Asians. [5][6][7][8] The prognosis in such cases has been variable.…”

Toll-Like Receptor 3 Polymorphism rs3775291 Is Not Associated with Choroidal Neovascularization or Polypoidal Choroidal Vasculopathy in Chinese Subjects

“…Recruitment of study subjects has been previously described [26,35] . In brief, study subjects included patients with exudative maculopathy and normal control subjects.…”