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Polypoidal choroidal vasculopathy appearing as classic choroidal neovascularisation on fluorescein angiography
  1. Hiroshi Tamura (htamura-kyt{at}umin.ac.jp),
  2. Akitaka Tsujikawa (tujikawa{at}kuhp.kyoto-u.ac.jp),
  3. Atsushi Otani,
  4. Norimoto Gotoh,
  5. Manabu Sasahara,
  6. Takanori Kameda,
  7. Daisuke Iwama,
  8. Yuko Yodoi,
  9. Michiko Mandai,
  10. Nagahisa Yoshimura (nagaeye{at}kuhp.kyoto-u.ac.jp)
  1. Kyoto University Graduate School of Medicine, Japan
  2. Kyoto University Graduate School of Medicine, Japan
  3. Kyoto University Graduate School of Medicine, Japan
  4. Kyoto University Graduate School of Medicine, Japan
  5. Kyoto University Graduate School of Medicine, Japan
  6. Kyoto University Graduate School of Medicine, Japan
  7. Kyoto University Graduate School of Medicine, Japan
  8. Kyoto University Graduate School of Medicine, Japan
  9. Kyoto University Graduate School of Medicine, Japan
  10. Kyoto University Graduate School of Medicine, Japan

    Abstract

    Aims: To study the visual prognosis and ocular characteristics of eyes with polypoidal choroidal vasculopathy (PCV) that appear to have classic choroidal neovascularisation (CNV) on fluorescein angiography (FA).

    Methods: We reviewed retrospectively 38 eyes with PCV that appear to have classic CNV on FA. Lesions were examined with indocyanine green angiography, FA, and optical coherence tomography (OCT).

    Results: In all cases OCT showed subretinal material with moderate reflectivity that corresponded in location to the classic CNV. At the final visit, the subretinal material resolved completely in 14 eyes (36.8%, resolved group), but it resolved only incompletely in 24 eyes (63.2%, persisted group) after photodynamic therapy (PDT). Visual acuity in the resolved group (0.35 ±0.41 in log MAR) was significantly better than that in the persisted group (0.84 ±0.24) at the final visit (P < 0.001). The subretinal material seen before treatment was more frequently seen in subfovea in the persisted group (87.5% vs 42.9%, P = 0.007). Also, this material were located adjacent to polypoidal lesionsmore often in the resolved group (92.9% vs 58.3%, P = 0.030).

    Conclusions: Eyes with PCV sometimes show classic CNV with subretinal material apparent on OCT, and PCV is thus attributed to type 2 CNV or to pure fibrinous tissue without CNV. Visual prognosis in eyes with type 2 CNV is poor, and though it is difficult to discriminate type 2 CNV from pure fibrin deposition before treatment, type 2 CNV is seen more often in the subfovea and is typically separate from the polypoidal lesions.

    • choroidal neovasularisation
    • fibrinous tissue
    • photodynamic therapy
    • polypoidal choroidal vasculopathy

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