scholarly journals Polypoidal Choroidal Vasculopathy Complicating Retinal Laser in Quiescent Uveitis

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Tomas R. Burke ◽  
Susan L. Lightman
Keyword(s):  
Lupus Erythematosus ◽  
Polypoidal Choroidal Vasculopathy ◽  
Retinal Vasculitis ◽  
Subretinal Fluid ◽  
Fundus Fluorescein Angiography ◽  
Pan Retinal Photocoagulation ◽  
Branching Vascular Network ◽  
Previously Treated ◽  
Choroidal Vasculopathy ◽  
Retinal Photocoagulation

A 58-year-old Afro-Caribbean gentleman with a diagnosis of quiescent systemic lupus erythematosus- (SLE-) related occlusive retinal vasculitis was previously treated with sector pan-retinal photocoagulation in his right eye to control temporal retinal neovascularization. At routine review he was found to have a focal area of subretinal fluid in the temporal macula sparing an ischaemic fovea. Fundus fluorescein angiography and indocyanine green angiography confirmed a branching vascular network (BVN) and terminal polys (i.e., polypoidal choroidal vasculopathy (PCV)). Interestingly, the BVN arose within an old laser scar. To our knowledge this is the first report of PCV in uveitis in an Afro-Caribbean patient and of the lesions arising within a laser scar.

scholarly journals The implications of subretinal fluid in pachychoroid neovasculopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geun Woo Lee ◽  
Hyeon Cheol Roh ◽  
Se Woong Kang ◽  
A. Young Kim ◽  
Hoon Noh ◽  
...  
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Polypoidal Choroidal Vasculopathy ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Subretinal Fluid ◽  
Longitudinal Changes ◽  
History Of ◽  
Pachychoroid Neovasculopathy ◽  
Choroidal Vasculopathy ◽  
Epidemiological Parameters

AbstractThis study aimed to identify the clinical characteristics and longitudinal changes in exudative pachychoroid neovasculopathy (PNV) and non-exudative PNV. This retrospective cohort study involved 81 eyes of PNV diagnosed by multimodal imaging including optical coherence tomography angiography. At baseline, they were divided into exudative PNV group and non-exudative PNV group depending on the presence of subretinal fluid. The clinical features of both groups and the longitudinal changes were investigated and compared. There were 55 eyes with non-exudative PNV and 26 eyes with exudative PNV. Individuals with non-exudative PNV were older, more frequently asymptomatic and had a higher prevalence of polypoidal choroidal vasculopathy in the opposite eye (all P’s < 0.05). Whereas individuals with exudative PNV showed thicker choroid and more frequent history of central serous chorioretinopathy (all P’s < 0.001). During about 12 months of longitudinal observation, the transformation into polypoidal choroidal vasculopathy was noted in 4 eyes of non-exudative PNV group, whereas in none of the exudative PNV group. Exudative PNV and non-exudative PNV seem to be separate entities with different epidemiological parameters. Non-exudative PNV, which is frequently found without symptoms at an older age, is suspected to be the significant precursor lesion of polypoidal choroidal vasculopathy. In contrast, exudative PNV may share the same pathophysiology as central serous chorioretinopathy.

scholarly journals Polypoidal choroidal vasculopathy in pachychoroid: combined treatment with photodynamic therapy and Aflibercept

2021 ◽  
Author(s):  
Maria Vadalà ◽  
Massimo Castellucci ◽  
Giulia Guarrasi ◽  
Giovanni Cillino ◽  
Vincenza Maria Elena Bonfiglio ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Polypoidal Choroidal Vasculopathy ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Subretinal Fluid ◽  
Clinical Activity ◽  
Monthly Basis ◽  
Choroidal Vasculopathy

Abstract Introduction To evaluate the effects of combined therapy using intravitreal Aflibercept (IVA) and photodynamic therapy (PDT) on polypoidal choroidal vasculopathy related to pachychoroid disease (PPCV).Methods Patients with PPCV were treated with PDT combined with 3 IVA injections on a monthly basis, followed by pro re nata criteria. The 12-month follow-up consisted of multiple revaluations of visual acuity and SSOCT parameters of clinical activity.Results Nineteen eyes were included in the study; mean age was 65.5 years. Visual acuity improved after 12 months (0.35 ± 0.25 to 0.2 ± 0.20 logMAR, p = 0.005). Percentage of eyes with intraretinal and subretinal fluid reduced from baseline to the 12-month follow-up (from 52.6–10.5%, p = 0.12, and from 89.5–5.3% p = 0.0009, respectively). Central retinal and mean macular thicknesses reduced (258 ± 39.6 to 204.8 ± 38.8 µm p = 0.04 and 293.8 ± 32.1 to 248.1 ± 29.6 µm p = 0.017 respectively). Central choroidal and mean choroidal thicknesses also displayed a reduction (328.6 ± 54.9 to 289.8 ± 44.6 µm p = 0.001 and 314.5 ± 55.3 to 287.9 ± 47.6 µm p = 0.015 respectively). The mean number of injections was 4.6/year.Conclusion The results support the use of a combined therapy with Aflibercept and PDT in PPCV. This treatment would act in synergy, with anti-VEGF controlling exudation and PDT closing the aneurysmal vessel and reducing choroidal congestion.

scholarly journals Characteristics of polypoidal choroidal vasculopathy in the Malaysian population

2021 ◽  
Vol 3 (3) ◽  
pp. 141-158
Author(s):  
Mae-Lynn Catherine Bastion ◽  
Rona Asnida Nasaruddin ◽  
Hon Seng Wong ◽  
Amelia Lay Suan Lim ◽  
Norshamsiah Md Din
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Morphological Characteristics ◽  
Fundus Photography ◽  
Fundus Fluorescein Angiography ◽  
Cross Sectional ◽  
Unilateral Disease ◽  
Discrete Area ◽  
Ophthalmologic Examination ◽  
Average Size ◽  
Choroidal Vasculopathy

Introduction: Polypoidal choroidal vasculopathy (PCV) is a distinct clinical entity, characterized by focal hyperfluorescence in the early phase of indocyanine green angiography (ICGA), with or without its associated branching vascular network (BVN).Purpose: To report the angiographic characteristics of PCV on ICGA in presumed PCV patients.Study design: Descriptive cross-sectional study.Materials and methods: This study involved 36 suspected PCV patients who attended the Ophthalmology Clinic, Universiti Kebangsaan Malaysia Medical Centre from June 1, 2012 to May 31, 2013. All patients underwent complete ophthalmologic examination including colour fundus photography, ICGA, and fundus fluorescein angiography. ICGA images of confirmed PCV patients were analysed.Results: Twenty-five out of 36 eyes (69.4%) were diagnosed to have PCV based on ICGA. Mean age of confirmed PCV patients was 66.4 ± 8.42 years, with predominance of males (n = 17) and Chinese ethnicity (n = 19). Best-corrected visual acuity (BCVA) was between 6/6 and 6/18 in 64%. All 25 patients had unilateral disease. Average size of PCV lesions was 1461.4 ± 864.4 μm. The lesions were mostly concentrated in the extrafoveal region (n = 15, 60%). Lesion formation was cluster in 56% (n = 14), single in 32% (n = 8), string in 4% (n = 1), and combination in 8% (n = 2). The majority involved a single discrete area. Polyp pulsation was detected in six eyes, while seven eyes revealed nodular hyperfluorescence when viewed stereoscopically. BVN was evident in 56% (n = 14). Fifteen eyes demonstrated the hypofluorescent halo, while no hyperfluorescent ring was seen in this study population. Late geographical hyperfluorescence (LGH) was noted in seven eyes (28%). There was no significant association between the morphological characteristics of PCV, i.e., size of lesion, location, formation, discrete area involved, and LGH with BCVA.Conclusion: The demographic, clinical, and angiographic features observed in this study were in agreement with other previously published Asian studies. However, we found no association between the morphological characteristics of PCV with BCVA.

scholarly journals Modern aspects of polypoidal choroidal vasculopathy diagnosis and treatment

2019 ◽  
Vol 12 (3) ◽  
pp. 93-100
Author(s):  
Konstantin V. Sokolov ◽  
Alexey K. Smirnov
Keyword(s):  
Clinical Practice ◽  
Polypoidal Choroidal Vasculopathy ◽  
European Population ◽  
Age Related Macular Degeneration ◽  
Universal Method ◽  
Distinctive Features ◽  
Anti Vegf ◽  
Age Related ◽  
Branching Vascular Network ◽  
Choroidal Vasculopathy

Polypoidal choroidal vasculopathy (PCV) is one of the choroidal neovascularization forms, being a subtype of neovascular age-related macular degeneration (nAMD). These two conditions share many characteristics, while PCV has some distinctive features with aneurysmal dilatations (polyps) at the end of abnormal branching vascular network being the most specific of them. Low documented incidence of PCV in European population (up to 13%) may be related to the absence of indocyanin-green angiography (ICG) the only reliable method for PCV diagnosis confirmation in routine clinical practice. In that regard, there should be a universal method of treatment suitable for any patient with nAMD irrespectively of whether he or she has PCV. To date, there is no common approach to PCV treatment anti-VEGF therapy, photodynamic therapy (PDT), and combination of these methods are used in clinical practice. Key diagnostic criteria helping to suspect the presence of PCV without ICG as well as results of clinical trials aimed at assessing effectiveness of different anti-VEGF agents as monotherapy or in combination with PDT are described in this article.

Subthreshold Yellow Wavelength Micropulse Laser Photostimulation Treatment in a Patient with Suspected Polypoidal Choroidal Vasculopathy

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Isik MU ◽  
◽  
Degirmenci MFK ◽  
Saglik A ◽  
◽  
...  
Keyword(s):  
Laser Treatment ◽  
Polypoidal Choroidal Vasculopathy ◽  
Indocyanine Green Angiography ◽  
Subretinal Fluid ◽  
Case Presentation ◽  
Pigment Epithelial ◽  
Micropulse Laser ◽  
Large Groups ◽  
Choroidal Vasculopathy

Purpose: The aim is to discuss the efficacy of micropulse laser treatment in a patient suspected of polypoidal choroidal vasculopathy. Case Presentation: A 61-year-old male patient presented with decreased vision in his left eye. He had a dome-shaped lesion below the macula and macular swelling in the fundus examination. Optical Coherence Tomography (OCT) showed neurosensorial serous detachment of the macula and polypoid appearance in the region consistent with the dome-shaped lesion. The patient was recommended Flourescein Angiography (FA), indocyanine green angiography (ICGA), but for economic reasons he refused to perform ICGA. After that, only FA was performed. As a result of the examinations, it was evaluated as central serous chorioretinopathy by a retina specialist. Three months later, because of subretinal fluid persistence, micropulse laser treatment including polyp-like lesion was applied. Results: At the 6th month follow-up, it was found that the fluid completely regressed and the Pigment Epithelial Detachment (PED) appearance occurred in place of the polypoidal appearance in OCT. In the 22nd month, subretinal fluid disappeared completely and PED appearance was observed. Conclusions: Although the characteristics of OCT of this case is similar to the OCT appearance in PCV, it would be more reasonable to consider this case as CSC in the light of current information, as this case responded to MPL treatment. Therefore, prospective studies with large groups are needed.

POLYPOIDAL CHOROIDAL VASCULOPATHY IN CAUCASIANS: MORPHOLOGICAL FINDINGS FROM MULTIMODAL RETINAL IMAGING

2021 ◽  
Author(s):  
Jorge M. Simão ◽  
Cláudia V. Farinha ◽  
João P. Marques ◽  
Sandrina Nunes ◽  
Isabel M. Pires ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Morphological Features ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Soft Drusen ◽  
The Mean ◽  
Choroidal Vasculopathy ◽  
Sd Oct

Purpose: To characterize the morphological features of polypoidal choroidal vasculopathy (PCV) in a large Caucasian population. Methods: A multicenter, cross-sectional study of treatment-naïve patients with PCV. Baseline fundus photography, spectral-domain optical coherence tomography (SD-OCT), fluorescein and indocyanine green angiography (FA,ICGA) were assessed by trained medical graders. Typical PCV features were explored, and retinal and choroidal thickness (RT,CT) measurements were performed. Results: Seventy-nine eyes of 73 patients (mean age,72.6±11.9 years) were included. ICGA identified macular polyps in 89.9% of cases. SD-OCT revealed mostly subretinal fluid (93.6%) and a retinal pigment epithelium (RPE) detachment in 91.4%, with sharp protrusion in 67.0%. Polyp-like structures were seen in 74.3%, mostly adherent to an elevated RPE (69.6%). Type 1 neovascularization (NV) was identified in 74.7%, while 16.5% had a mixed NV. The mean macular CT was 220.9±83.2 µm (range,67.9-403.6). Diffuse and focal pachychoroid were observed in 26.6% and 30.4%. Soft drusen were reported in 62.0%, but retinal hemorrhage occurred in only 19.0%. Conclusion: The morphological features of PCV in Caucasians are similar to those reported in Asians. Pachychoroid signs were found in nearly half of our cohort. However, the mean age at presentation, high prevalence of soft drusen, and low prevalence of large subretinal hemorrhages make PCV closer to age-related macular degeneration in this ethnic group.

scholarly journals Clinical Implications of Pachyvessels in Polypoidal Choroidal Vasculopathy

2020 ◽  
Author(s):  
Nobuo Ijuin ◽  
Hiroki Tsujinaka ◽  
Hiromasa Hirai ◽  
Hironobu Jimura ◽  
Shigeya Nakao ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Enhanced Depth Imaging ◽  
Fundus Photography ◽  
Treatment Naïve ◽  
The Relationship ◽  
Choroidal Vessels ◽  
Choroidal Vasculopathy ◽  
Fellow Eyes

Abstract Purpose: Polypoidal choroidal vasculopathy (PCV) is one of the disorders within the pachychoroid spectrum diseases. The presence of pachyvessels is one of the characteristics of pachychoroid disorders. However, the relationship between the presence of pachyvessels and the clinical characteristics of PCV eyes has not been determined. The purpose of this study was to determine the relationship between the presence of choroidal pachyvessels and the clinical characteristics of eyes with PCV. Methods: The medical records of patients who were diagnosed with PCV and were treatment-naïve were reviewed. Fluorescein and indocyanine green angiography, fundus photography, spectral domain optical coherence tomography (SD-OCT), and enhanced depth imaging OCT (EDI-OCT) were used to obtain images of the choroid. The presence of pathologically dilated outer choroidal vessels, pachyvessels, was determined by ICGA images. These pachyvessels were confirmed to correspond with the large choroidal vessels in the EDI OCT images. The PCV eyes were divided into two groups based on the presence or absence of pachyvessels and clinical features and subfoveal choroidal thickness (SFCT) were evaluated between the two groups. Results: Eighty-six eyes of 84 patients with PCV were evaluated. Pachyvessels were detected in 48 eyes (55.8％). The mean SFCT was 203.9 ± 83.9 μm in all 86 eyes, and it was significantly thinner in eyes with pachyvessels (+) than without pachyvessels (-) (183.2 ± 58.4 μm vs 230.2 ± 103.1 μm; P =0.01). The differences in the incidence of subretinal fluid, pigment epithelial detachments, and hemorrhages between the two groups were not significant. However, the PCV eyes in pachyvessels (+) group with hemorrhage had the thinnest choroid ( P =0.047). The choroidal features of the fellow eyes were similar to those of the PCV affected eyes, that is, the fellow eyes in pachyvessels (+) group had pachyvessels and the fellow eyes in pachyvessels (-) group did not have pachyvessels. Conclusions: Pachyvessels were presented 55.8% in eyes with PCV, and these eyes had the thin SFCT. The presence of pachyvessels and attenuation of the inner choroid were probably due to the pathological changes in the eyes with PCV.

scholarly journals Polypoidal Choroidal Vasculopathy Diagnosis and Neovascular Activity Evaluation Using Optical Coherence Tomography Angiography

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Georges Azar ◽  
Vivien Vasseur ◽  
Corinne Lahoud ◽  
Catherine Favard ◽  
Flore De Bats ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Polypoidal Choroidal Vasculopathy ◽  
Optical Coherence Tomography Angiography ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Swept Source ◽  
Multicentric Study ◽  
Age Related ◽  
Choroidal Vasculopathy

Purpose. To examine choroidal neovascularization (CNV) characteristics in patients with exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV), using swept-source optical coherence tomography angiography (SS-OCTA), and investigate agreement with OCT B-scan, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) by two different examiners. Methods. This is a retrospective multicentric study that involved patients with a history of AMD and PCV. Examiner A, who had access to OCTA, B-scan OCT, FFA, and ICGA imaging, had to differentiate between AMD and PCV, study the activity of AMD using Coscas’ criteria (active vs. quiescent), and categorize PCV subtypes, while examiner B had only access to OCTA. Then, the diagnostic concordance was assessed between both examiners. Results. A total of 27 patients (11 females (40.7%) and 16 males (59.3%), P = 0.231 ) were included in the analysis. Among those, 13 patients presented with neovascular AMD and 14 patients with PCV. There were 92.3% of correct answers regarding appropriate diagnosis and lesion characterization among AMD patients, against 61.5% of correct answers among PCV patients. The overall interrater reliability agreement between examiners, using Cohen’s kappa coefficient ( κ ) was 0.70 (0.5082-0.8916). Disagreement was found with one active AMD misdiagnosed as inactive AMD, three inactive PCV misdiagnosed as inactive AMD, and one inactive PCV misdiagnosed as active AMD. Conclusion. SS-OCTA alone remains limited in some specific phenotypes of PCV, which suggests the ongoing role of B-scan OCT associated with FFA and ICGA in the diagnosis of these conditions.

Sign in / Sign up

Export Citation Format

Share Document