Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration characterized by peculiar polypoidal lesions seen on indocyanine green angiography (IA). However, precise pathogenesis of PCV has yet to be clearly elucidated. In addition to the conventional diagnostic tools, we evaluated the clinical characteristics of PCV by means of relatively new and noninvasive imaging methods, namely, fundus autofluorescence photography and enhanced depth imaging optical coherence tomography, and found novel observations.
This article focuses especially on the relationship between the clinical characteristics of PCV and choroidal vascular hyperpermeability. Choroidal vascular hyperpermeability, which is visualized as multifocal hyperfluorescence in the middle and late phases on IA, was originally described as a characteristic finding in central serous chorioretinopathy (CSC). Of the 89 patients with PCV in our case series, 31 patients (34.8%) demonstrated choroidal vascular hyperpermeability. The patients with PCV associated with choroidal vascular hyperpermeability demonstrated more frequently bilateral occurrence of neovascular membrane, a history of CSC, a thickened choroid and poor responses to ranibizumab therapy than those without choroidal vascular hyperpermeability. Our results provide further understanding of PCV and new therapeutic implications.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 118: 927-942, 2014.