Article Text
Abstract
Background/aim: There are two theories on the pathogenesis of polypoidal choroidal vasculopathy (PCV): variants in choroidal neovascularisation (CNV) and inner choroidal vessel abnormalities. On indocyanine green angiography (IGA) with a video camera system, PCV has a characteristic appearance, but inadequate image quality has made detailed interpretation difficult. This study aims to improve imaging, using confocal scanning laser ophthalmoscopy (SLO), to elucidate the pathogenesis of PCV.
Methods: High speed IGA with confocal SLO of 45 eyes (44 patients) showed typical PCV findings of a branching vascular network and polypoidal lesions.
Results: Vessels comprising branching networks began to fill simultaneously with the surrounding choroidal arteries in 38 eyes. Small numbers of vessels filling within a branching network, in the arterial and arteriovenous phases of IGA, showed focal dilatation, constriction, and tortuousity. Vessel abnormalities, corresponding to polypoidal lesions, existed within a network in eight eyes and included loops similar in calibre to network vessels, and numerous microaneurysmal dilatations of small vessels. Vessel pulsation was seen in 24 eyes.
Conclusion: PCV is caused by inner choroidal vessel abnormalities, not CNV.
- AMD, age related macular degeneration
- CNV, choroidal neovascularisation
- IGA, indocyanine green angiography
- OCT, optical coherence tomography
- PCV, polypoidal choroidal vasculopathy
- RPE, retinal pigment epithelium
- SLO, scanning laser ophthalmoscopy
- confocal scanning laser ophthalmoscopy
- high speed indocyanine green angiography
- polypoidal choroidal vasculopathy
- AMD, age related macular degeneration
- CNV, choroidal neovascularisation
- IGA, indocyanine green angiography
- OCT, optical coherence tomography
- PCV, polypoidal choroidal vasculopathy
- RPE, retinal pigment epithelium
- SLO, scanning laser ophthalmoscopy
- confocal scanning laser ophthalmoscopy
- high speed indocyanine green angiography
- polypoidal choroidal vasculopathy
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