Polypoidal choroidal vasculopathy with an appearance similar to classic choroidal neovascularisation on fluorescein angiography

Polypoidal choroidal vasculopathy (PCV) is a distinct clinical entity characterised by a branching choroidal vascular network and polypoidal vascular dilations at the border of the vascular network. PCV is associated with serous or haemorrhagic detachments of the retinal pigment epithelium (RPE) and neurosensory retina secondary to leakage and bleeding from the choroidal vascular lesions. PCV has been referred to by various names, including idiopathic PCV,1 posterior uveal bleeding syndrome,2 and multiple recurrent retinal pigment epithelial detachment in black women.3 4 Although the pathogenesis of PCV is not clearly understood, it is thought to originate in an abnormality of the inner choroidal vessels.1 ^–7 Clinically, polypoidal vascular dilations may appear as orange-red lesions under the RPE on biomicroscopic examination. Indocyanine green angiography (IA) provides definitive diagnosis of PCV because it clearly shows a branching vascular network and polyp-like structures from the choroidal circulation.5 6 These vascular abnormalities seem to be a variant of choroidal neovascularisation (CNV), referred to as polypoidal CNV,8^–10 and PCV is often referred to as polypoidal age-related macular degeneration (ARMD).11

PCV previously was thought to be a rare disease. Recent reports have shown that PCV occurs extensively in patients of all races.6 9 10 12^–18 It also seems …