Age-Related Scattered Hypofluorescent Spots on Late-Phase Indocyanine Green Angiography as Precursor Lesions of Polypoidal Choroidal Vasculopathy

Purpose: to study noninvasive diagnostic options for polypoidal choroidal vasculopathy (PCV) — a subtype of neovascular agerelated macular degeneration — by monitoring clinical progression, defining optical coherence tomography (OCT) findings specific for PCV and evaluating diagnostic utility of OCT angiography.Patients and methods. The study included 254 patients (292 eyes) with neovascular age-related macular degeneration. All patients underwent complex eye examination: visual acuity test, slit lamp biomicroscopy, ophthalmoscopy with 60 and 78D fundus lenses, fundoscopy with color filters, spectral-domain OCT, OCT angiography and biometry. Fluorescein angiography was performed in 66 cases. Indocyanine green angiography was employed in 16 patients with PCV. All statistical analyses were performed with IBM SPSS Statistics 19 software package.Results. In 14 of 16 patients (87.5%) indocyanine green angiography revealed round hyperfluorescent lesions which corresponded to ophthalmoscopy findings — subretinal reddish orange nodules localized primarily in the parafovea. In 11 cases (68.8%) the nodules were associated with hemorrhage and in 14 cases (87.5%) — with hard yellowish exudates. Comparative analysis of retinal anatomy allowed for defining typical OCT signs of PCV that distinguish the clinical entity from type 1 and 2 choroidal neovascular membranes: neurosensory retinal detachment in the parafovea (80.0%, p < 0.001) and hard exudates (71.9%, p < 0.001). OCT findings characteristic of PCV are dome-shaped pigment epithelium detachment (100%), bubble sign (94.74%), notch sign (68.4%) and double layer sign (92.9%).Conclusion. Noninvasive diagnosis of polypoidal choroidal vasculopathy should encompass clinical signs, fundoscopy findings, OCT-based morphometry and OCT angiography criteria. OCT angiography has high diagnostic value and enables detection of branching vascular network and polypoidal formations.

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Use of fluorescein and indocyanine green angiography in polypoidal choroidal vasculopathy patients following photodynamic therapy

Canadian Journal of Ophthalmology ◽

10.3129/i08-153 ◽

2008 ◽

Vol 43 (6) ◽

pp. 678-682 ◽

Cited By ~ 5

Author(s):

Roman Windisch ◽

Bettina K. Windisch ◽

Alan F. Cruess

Keyword(s):

Photodynamic Therapy ◽

Indocyanine Green ◽

Polypoidal Choroidal Vasculopathy ◽

Indocyanine Green Angiography ◽

Choroidal Vasculopathy

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Comparison of indocyanine green angiography and optical coherence tomographic angiography in polypoidal choroidal vasculopathy

Eye ◽

10.1038/eye.2016.232 ◽

2016 ◽

Vol 31 (1) ◽

pp. 45-52 ◽

Cited By ~ 25

Author(s):

K Takayama ◽

Y Ito ◽

H Kaneko ◽

K Kataoka ◽

T Sugita ◽

...

Keyword(s):

Indocyanine Green ◽

Polypoidal Choroidal Vasculopathy ◽

Indocyanine Green Angiography ◽

Optical Coherence ◽

Tomographic Angiography ◽

Choroidal Vasculopathy

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Polypoidal Choroidal Vasculopathy in Congolese Patients

Journal of Ophthalmology ◽

10.1155/2020/4103871 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Nelly N. Kabedi ◽

David L. Kayembe ◽

Gloria M. Elongo ◽

Jean-Claude Mwanza

Keyword(s):

Optical Coherence Tomography ◽

Indocyanine Green ◽

Polypoidal Choroidal Vasculopathy ◽

Indocyanine Green Angiography ◽

Clinical Presentation ◽

Case Series ◽

Systemic Hypertension ◽

Optical Coherence ◽

Blurred Vision ◽

Choroidal Vasculopathy

Purpose. Polypoidal choroidal vasculopathy (PCV) is a visually debilitating disease that mostly affects people of African and Asian heritage. Indocyanine green angiography (ICGA) is the recommended exploratory method for definitive diagnosis. The disease has been extensively described in Asians and Caucasians, but not in Africans. This study was conducted to document the clinical presentation and optical coherence tomography features of polypoidal choroidal vasculopathy (PCV) in Congolese patients. Methods. A prospective case series of patients with PCV was performed between January 2017 and June 2019. Routine ocular examination was performed including best corrected visual acuity measurement, slit-lamp examination, dilated direct fundoscopy, and spectral domain optical coherence tomography (OCT). The diagnosis was based on a combination of clinical and OCT signs. Results. Fourteen patients were diagnosed with PCV during this period. The average age was 64.7 ± 6.9 years. There were 8 females. Ten (71.4%) patients had systemic hypertension. Most patients (n = 9, 64.3%) had bilateral involvement. Blurred vision was the most common complaint (71.4%). The main clinical presentation was subretinal exudates, seen in 19 (82.6%) eyes of 11 (78.6%) patients and subretinal hemorrhage in 10 (43.5%) eyes. Macular localization was found in 16 eyes (69.5%) of 12 (85.7%) patients. Drusen were observed in 35.7% of the patients. On OCT imaging, thumb-like pigment epithelial detachment and subretinal exudation were the most frequent features, observed in 92.9% and 71.4% of the patients, respectively. Conclusions. PCV in Congolese patients showed features that are more similar to those observed in Caucasians. In this setting where indocyanine green angiography is not available, OCT facilitates the diagnosis of PCV.

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Quantitative analysis of choroidal vasculature in polypoidal choroidal vasculopathy using ultra-widefield indocyanine green angiography

Scientific Reports ◽

10.1038/s41598-020-75506-7 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Gahyung Ryu ◽

Cheolwon Moon ◽

Jano van Hemert ◽

Min Sagong

Keyword(s):

Indocyanine Green ◽

Treatment Response ◽

Polypoidal Choroidal Vasculopathy ◽

Indocyanine Green Angiography ◽

Vascular Density ◽

Poor Treatment ◽

Treatment Naïve ◽

Healthy Control ◽

Choroidal Vasculature ◽

Choroidal Vasculopathy

Abstract Polypoidal choroidal vasculopathy (PCV) is a common choroidal vascular disease particularly in Asians. However, the underlying pathogenesis of PCV is still yet to be fully elucidated, and the correlation between choroidal vasculature and treatment response of PCV are poorly understood. Accordingly, we sought to find clues to understand the pathogenesis and prognosis of PCV by quantitatively evaluating choroidal vasculature from the entire fundus using ultra-widefield (UWF) indocyanine green angiography (ICGA). In this study, 32 eyes from 29 patients with treatment naïve PCV and 30 eyes from 30 healthy control participants were enrolled. Choroidal vascular density (CVD) of PCV eyes was higher than normal eyes in majority regions including the periphery. CVD was positively correlated with choroidal thickness and choroidal hyperpermeability, supporting that the pathogenesis of PCV may include choroidal congestion and dilatation. Thicker choroid and higher CVD were also correlated with poor treatment response after anti-VEGF injections. The CVD, quantified from UWF ICGA can also be used as an effective image biomarker to predict the treatment response in PCV.

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