scholarly journals Noninvasive multimodal imaging in diagnosing polypoidal choroidal vasculopathy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Song Xia ◽  
Youxin Chen
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Multimodal Imaging ◽  
High Sensitivity ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Diagnostic Strategy ◽  
Imaging Features ◽  
Imaging Methods ◽  
Age Related ◽  
Choroidal Vasculopathy

Abstract Purpose To investigate the diagnostic accuracy of noninvasive multimodal imaging methods in diagnosing polypoidal choroidal vasculopathy (PCV) and distinguishing PCV from typical neovascular age-related macular degeneration (nvAMD). Methods Retrospective study. Imaging features of noninvasive multimodal imaging methods, including fundus photography (FP), B-scan optical coherence tomography (OCT), en face OCT, OCT angiography, and autofluorescence, of 103 eyes with PCV or typical nvAMD were reviewed. Diagnostic strategy was established based on imaging features and was validated in other 105 eyes with PCV or typical nvAMD. Results Features of subretinal orange nodule on FP, thumb-like PED on OCT, notched PED on OCT, bubble sign on OCT, and Bruch’s membrane depression under serosanguinous PED on OCT were more common. When the diagnostic strategy of using at least 2 of 5 features was performed, there is 0.88 sensitivity and 0.92 specificity for diagnosing PCV. The results of the validation test further confirmed the diagnostic strategy with 0.94 sensitivity and 0.93 specificity. Conclusions Noninvasive multimodal imaging, especially FP and B-scan OCT, provide high sensitivity and specificity for diagnosing PCV and distinguishing PCV from typical nvAMD, when at least 2 of 5 suggestive imaging features are present.

Choroidal neovascular membranes secondary to intraocular tuberculosis misdiagnosed as neovascular age-related macular degeneration

2017 ◽  
Vol 28 (2) ◽  
pp. 216-224 ◽  
Author(s):  
Alessandro Invernizzi ◽  
Aniruddha Agarwal ◽  
Maura Di Nicola ◽  
Fabio Franzetti ◽  
Giovanni Staurenghi ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Choroidal Neovascularization ◽  
Multimodal Imaging ◽  
Age Related Macular Degeneration ◽  
Enhanced Depth Imaging ◽  
Fundus Photography ◽  
Imaging Features ◽  
Neovascular Amd ◽  
Age Related ◽  
Intraocular Tuberculosis

Purpose: Intraocular tuberculosis (IOTB) can be complicated by choroidal neovascularization (CNV). However, when the CNV development is not accompanied by clear signs of inflammation, the etiology can be missed, especially in countries nonendemic for tuberculosis. We describe the clinical and imaging features of CNVs presenting as the first sign of IOTB initially misdiagnosed as exudative age-related macular degeneration (AMD). Methods: A retrospective review of clinical and imaging data of patients initially misdiagnosed with neovascular AMD later diagnosed with inflammatory CNV secondary to IOTB at tertiary referral centers was conducted. Features of fundus photography, fluorescein angiography, indocyanine green angiography, and enhanced depth imaging optical coherence tomography were analyzed. Distinguishing features between neovascular AMD and IOTB-associated CNV were evaluated. Results: Five patients over 55 years of age, erroneously diagnosed with exudative AMD, were included in the study. Multimodal imaging analysis allowed identification of peculiar choroidal alterations such as choroidal granulomas or choroiditis suggestive for posterior uveitis. Systemic workup for granulomatous uveitis including immunologic investigations such as tuberculin skin test or QuantiFERON TB Gold® and radiologic investigations revealed tubercular etiology in all the cases, allowing correct diagnosis and management of the uveitis and related CNV. Conclusions: Choroidal neovascularization represents a rare and unusual presenting sign of IOTB that can be misleading especially when it occurs in the elderly living in countries with low prevalence of the disease. Multimodal imaging can be helpful and should be employed, especially in atypical cases of CNV, in order to avoid misdiagnosis and/or diagnostic delays.

Polypoidal Choroidal Vasculopathy

2020 ◽  
pp. 118-125
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Imaging Features ◽  
Current Management ◽  
Choroidal Circulation ◽  
Management Guidelines ◽  
Age Related ◽  
Endothelial Growth Factor ◽  
Choroidal Vasculopathy

Polypoidal choroidal vasculopathy (PCV) is an age-related macular degeneration (AMD) subtype and is seen particularly in Asians. There is a disparity in response to intravitreal anti-vascular endothelial growth factor (VEGF) treatments between PCV and typical AMD, and the preferred treatment for PCV has remained unclear. Recent researches suggest that PCV belongs to a condition characterized by pachychoroid and disturbance in the choroidal circulation seems to be central to its pathogenesis. In this review, we summarize the clinical and imaging features, diagnostic criteria, and current management guidelines of PCV.

scholarly journals Multimodal Imaging of Unaffected Fellow Eyes in Patients with Polypoidal Choroidal Vasculopathy and Neovascular Age-Related Macular Degeneration

2021 ◽  
Vol 72 (2) ◽  
pp. 121-127
Author(s):  
Supalert Prakhunhungsit
Keyword(s):  
Macular Degeneration ◽  
Polypoidal Choroidal Vasculopathy ◽  
Multimodal Imaging ◽  
Fundus Autofluorescence ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Choroidal Vasculopathy ◽  
Fellow Eyes ◽  
Sd Oct

Objective: To identify retinal abnormalities in the unaffected fellow eyes of patients with unilateral polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (n-AMD). Methods: In this cross-sectional, retrospective case series, the medical records of patients with PCV and n-AMD were reviewed and the baseline patient characteristics recorded. Abnormal findings on spectral-domain optical coherence tomography (SD-OCT) (steep/notched pigment epithelial detachment [PED], double-layer sign, hyporeflective lumen within the PED), fundus autofluorescence (FAF) (ring/patch patterns), and indocyanine green angiography (ICGA) (punctate hyperfluorescence spot [PHS]) were studied. Results: Seventy-one fellow eyes of patients with PCV and 64 fellow eyes of patients with n-AMD were included. FAF showed abnormalities in 26 (36.6%) and 33 (51.6%) fellow eyes of those with PCV and n-AMD, respectively (p=0.081). SD-OCT detected abnormalities in 25 (35.2%) and 36 (56.3%) fellow eyes of those with PCV and n-AMD, respectively (p=0.014). ICGA detected PHS in 47 (66.2%) and 34 (53.1%) fellow eyes of PCV and n-AMD, respectively (p=0.122). Conclusion: Multimodal imaging showed abnormalities in most asymptomatic fellow eyes of patients with PCV and n-AMD. Regular and long-term self-monitoring and fundus evaluation are important for these patients. The current findings support the differences in the pathogeneses of PCV and n-AMD.

scholarly journals One-year outcomes of fixed-dosing Aflibercept therapy for pre treated and naive polypoidal choroidal vasculopathy patient

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hun Gu Choo ◽  
Jin Hae Lee ◽  
Hyun Sub Oh ◽  
Soon Hyun Kim ◽  
Yong Sung You ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Vision Loss ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Research Information ◽  
Age Related ◽  
Case Series Study ◽  
Treatment Naïve ◽  
One Year ◽  
Choroidal Vasculopathy

Abstract Background Polypoidal choroidal vasculopathy (PCV) is a type of age-related macular degeneration that can cause permanent vision loss. The purpose of this paper was to report the one-year outcomes of fixed-dosing aflibercept therapy for the treatment of PCV. Methods This was a prospective, single-arm, interventional case series study of 25 PCV patients; 12 pre-treated and 13 treatment-naïve patients. The patients were treated and monitored for 12 months. Each patient was administered with an aflibercept (2.0 mg) injection every month for the first 3 months (the loading phase), and thereafter, once every 2 months. At every follow-up visit, best-corrected visual acuity (BCVA) test, fundus examination, and optical coherence tomography for measuring the central subfield macular thickness (CSMT) were performed. Fluorescein and indocyanine green angiography were conducted at baseline and at 4 and 12 months. Results After 12 months of aflibercept therapy, the mean BCVA of the patients significantly improved from 65.48 letters at baseline to 69.91 letters (p=0.001), and the CSMT significantly decreased from 406.92 um at baseline to 276.12 um (p< 0.001). Additionally, ten patients (40%) showed complete polyp regression. The treatment-naïve patients showed a statistically significant improvement in BCVA from 66.58 letters at baseline to 76.36 letters at 12 months, and a significant decrease in CSMT, from 462 to 243 um. In the pre-treated group, there was no change in BCVA (64.46 letters), and the decrease in CSMT from 356.08 to 303.69 um was not statistically significant. Conclusions The fixed-dosing aflibercept regimen is effective for treating patients with PCV and is more effective in treatment-naïve patients than in pre-treated patients. Trial registration Clinical Research Information Service (CRiS), Republic of Korea. Identifer: KCT0005798, Registered: Jan 20, 2021. Retrospectively registered, URL: https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=18546

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