Polypoidal Choroidal Vasculopathy in Congolese Patients

Abstract

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.

Polypoidal Choroidal Vasculopathy: An Update on Diagnosis and Treatment

“…As per initial reports, PCV was common among black females by as much as 57.1% to 80%. 1 Though predominantly reported from the Afro-Caribbean and Asian countries in the past, recent reports from the Caucasian population have also emerged, 2 , 3 giving this disease more global recognition and attention. Recent hospital/clinic-based epidemiological studies show PCV prevalence as high as 22–62% among presumed neovascular age-related macular degeneration (nAMD) cases in the Asian population 4 , 5 and about 10–20% in the Caucasian population.…”

Outcome of Peripapillary Polypoidal Choroidal Vasculopathy Treatment using Combination Therapy Intravitreal Ranibizumab and Thermal Retinal Laser Photocoagulation

“…It occurs in middle-aged Africans (between 50 and 65 years), with a female preponderance. [ 2 3 4 5 ] Studies among Asians show a male preponderance of PCV. [ 3 ] PCV affects persons of African and Asian descent more than Caucasians.…”