Polypoidal choroidal vasculopathy appearing as classic choroidal neovascularisation on fluorescein angiography
- Hiroshi Tamura (htamura-kyt{at}umin.ac.jp),
- Akitaka Tsujikawa (tujikawa{at}kuhp.kyoto-u.ac.jp),
- Atsushi Otani,
- Norimoto Gotoh,
- Manabu Sasahara,
- Takanori Kameda,
- Daisuke Iwama,
- Yuko Yodoi,
- Michiko Mandai,
- Nagahisa Yoshimura (nagaeye{at}kuhp.kyoto-u.ac.jp)
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Kyoto University Graduate School of Medicine, Japan
- Published Online First 21 February 2007
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.
