Polypoidal choroidal vasculopathy american society of retina. Although the polypoidal choroidal vasculopathy and agerelated macular degeneration have been known to share common genetic factors, its clinical characteristics suggest that polypoidal choroidal vasculopathy is a separate clinical entity from. In 1990, yannuzzi and colleagues first described idiopathic polypoidal choroidal vasculopathy ipcv macular disordera choroidal vasculopathy that causes haemorrhagic and exudative macular degenerationin 11 patients. Retina today polypoidal choroidal vasculopathy mayjune. Home january 2016 volume 36 issue 1 polypoidal choroidal vasculopathy. Evidence supports that symptomatic patients with pcv can have complete regression without severe vision loss with. Vitreous haemorrhage in massive hemorrhagic polypoidal. Polypoidal choroidal vasculopathyoct retina image bank. Polypoidal choroidal vasculopathy pcv has been recognised for almost two decades. Although the prognosis of pcv is commonly reported to be more favorable and the clinical course more stable as compared with exudative agerelated macular degeneration amd 24, the natural history of pcv, especially haemorrhagic pcv, is not clearly known and may not be as.
Polypoidal choroidal vasculopathy pcv is characterized by a network of branching inner choroidal vessels with terminal, polyplike aneurismal dilations. Update on polypoidal choroidal vasculopathy american. Idiopathic polypoidal choroidal vasculopathy definition. Pcv lesions are typically located beneath the rpe layer.
Clinical features of polypoidal choroidal vasculopathy and visual outcomes in the absence of classic choroidal neovascularization. Idiopathic polypoidal choroidal vasculopathy in japanese patients differs from that in american patients. Polypoidal choroidal vasculopathy complicating retinal laser in. Polypoidal chroidal vasculopathy retina image bank. The most common presenting symptom in pcv is decreased visual acuity va due to srf or srh. Polypoidal choroidal vasculopathy was first described as polypoidal, subretinal, vascular lesions associated with serous and hemorrhagic detachments of the retinal pigment epithelium rpe in a series of patients 1011 were women by yannuzzi et al. Polypoidal choroidal vasculopathy europe pmc article. Incidence and clinical patterns of polypoidal choroidal vasculopathy.
Unlike amd, which is most common in older caucasian women, pcv is seen more often in asians, africanamericans, and men, according to gregg t. Polypoidal choroidal vasculopathy pcv is a disease primarily affecting the vascular layer of blood vessels in the choroid pronounced core. Photodynamic therapy for polypoidal choroidal vasculopathy. Hemorrhage from the choroidal blood vessels near the macula of the retina. Polypoidal choroidal vasculopathy the american society. We present an unusual case of polypoidal choroidal vasculopathy pcv lying above the retinal pigment epithelium rpe in a 60yearold caucasian female. It is a benign melanocytic lesion typically pcv, also known as posterior uveal bleeding syndrome, is a condition characterized by chronic, multiple, recurrent serosanguinous retinal pigment epithelium detachments secondary to an abnormal network of underlying choroidal vessels. Polypoidal choroidal vasculopathy pcv is a disease of the choroidal vasculature. Pdf idiopathic polypoidal choroidal vasculopathy ipcv is uncommon condition. What are the current methods of diagnosing and treating pcv. Abstract polypoidal choroidal vasculopathy pcv is a subtype of subretinal neovascularization and a variant of agerelated macular degeneration.
Polypoidal choroidal vasculopathy is more common in asian populations. Choroidal nevus is the most common adult intraocular tumor of the ocular fundus. Peripheral exudative hemorrhagic chorio retinopathy pehcr, also referred to as eccentric disciform degeneration, extramacular disciform degeneration and peripheral age related retinal degeneration, is a degenerative condition affecting the peripheral fundus of elderly patients. Kokame, md, clinical professor of surgery at the university of hawaii john a. Previous studies have suggested disparity in response to intravitreal injections of antivascular endothelial growth factor vegf agents between pcv and typical amd, and thus, the preferred treatment for pcv has remained unclear. Recent advances in diagnosis and treatment of this disease entity have improved the management of pcv and its outcomes. Treatment of polypoidal choroidal vasculopathy retina today. These lesions were mostly in the macula 33 eyes 94%, with a few in the peripapillary area. Pigment epithelial detachment a and subretinal hemorrhage b are common manifestations. Serosanguineous detachments of the pigmented epithelium and exudative changes leading to subretinal fibrosis 3. The most common presenting diagnosis was exudative agerelated macular degeneration in 59%, and it took 17. Polypoidal choroidal vasculopathy pcv is currently recognized as a.
Clinical implications of pachyvessels in polypoidal choroidal. Idiopathic polypoidal choroidal vasculopathy ipcv has been recognized as a peculiar form of choroidal. Visual acuity va was recorded in etdrs letter count. We report the first case series in the taiwanese population. Idiopathic polypoidal choroidal vasculopathy in japanese patients.
Polypoidal choroidal vasculopathy pcv is a disease primarily affecting the vascular layer of blood vessels in the choroid pronounced core oid, resulting in damage to the overlying retina where the photoreceptor cells responsible for vision reside see illustration. Polypoidal choroidal vasculopathy pcv has been described since the 1980s with great variations in patient data in different countries. Fundus photos and indocyanine green angiography images were evaluated in a multicenter retrospective study to establish the diagnosis of pcv. Out of 7 pcv eyes, focal choroidal vascular dilation was noted in 3 eyes and diffuse choroidal vascular dilation was noted in 1 eye. It produces acute, painless, unilateral visual loss. Polypoidal choroidal vasculopathy with choroidal vascular. The aneurysmal dilatations, also known as polyps, may be found subfoveal, juxtafoveal, extrafoveal. Polypoidal choroidal vasculopathy with large vascular network. Polypoidal choroidal vasculopathy, pachychoroid, pachyvessels. Tateiwa hkuroiwa sgaun sarai jyoshimura n polypoidal choroidal vasculopathy with large vascular network. It has been considered to be a variant of neovascular agerelated macular degeneration amd. Previous studies have suggested disparity in response to. The diagnosis of pcv is often made based on funduscopic findings. Article as pdf 525 kb article as epub print this article.
The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Fundus fluorescein angiography and indocyanine green angiography confirmed a branching vascular network bvn and terminal polys i. Polypoidal choroidal vasculopathy treatment honolulu hawaii. Polypoidal choroidal vasculopathy linkedin slideshare. Characteristics of polypoidal choroidal vasculopathy. Additional file 1 figure s4 basic characteristics of sfct in this study. Polypoidal choroidal vasculopathy pcv is a retinal disorder characterized by the presence of aneurysmal polypoidal lesions in the choroidal vasculature. In some patients, progressive subretinal fibrosis can be observed. Spaide discussing pcv in the american academy of ophthalmology retina december 2012 clinical update on polypoidal choroidal vasculopathy. En face imaging of the choroid in polypoidal choroidal. More than 15 years ago, a peculiar hemorrhagic disorder of the macula was described as both posterior uveal bleeding syndrome18. Although the initial va in pcv patients with srf alone is usually better than patients with amd, it is often more resistant to antivegf therapy. In the past 2 decades, idiopathic polypoidal choroidal vasculopathy. Polypoidal choroidal vasculopathy is a disease with characteristic choroidal vascular abnormalities.
Neovascular agerelated macular degeneration amd is a leading cause of blindness in the developed world. It is present in both men and woman of many ethnicities, characterized by serosanguineous detachments of the pigmented epithelium and exudative changes that can commonly lead to subretinal fibrosis. Polypoidal choroidal vasculopathy polypoidal choroidal vasculopathy pcv is a disease primarily affecting the vascular layer of blood vessels in the choroid pronounced core oid, resulting in damage to the overlying retina where the photoreceptor cells responsible for vision reside see illustration. Pcv is associated with serous or haemorrhagic detachments of the retinal pigment epithelium rpe and neurosensory retina secondary to leakage and bleeding. Idiopathic polypoidal choroidal vasculopathy presenter dr.
The natural course of the disease often follows a remittingrelapsing course, and clinically, it is associated with chronic, multiple, recurrent serosanguineous detachments of the retinal pigment epithelium and neurosensory retina with long. Polypoidal choroidal vasculopathy pcv is a retinal disorder characterized by the presence of aneurysmal polypoidal lesions in the choroidal vasculature, resulting in damage to the overlying retina and loss of retinal pigment epithelium. Multiple areas of subretinal hemorrhage are visible in these photos. Polypoidal choroidal vasculopathy has also been reported in irish, french, german, and italian patients. Last modified by caroline bozell on may 16, 2014 rating appears in polypoidal choroidal vasculopathy conditionkeywords optical coherence tomography oct, polypoidal choroidal vasculopathy pcv. On fundus examination, the most suggestive findings of pcv are orangered subretinal. Polypoidal choroidal vasculopathy pcv is an agerelated macular degeneration amd subtype and is seen particularly in asians. Introduction polypoidal choroidal vasculopathy pcv is a disease of the choroidal vasculature. Polypoidal choroidal vasculopathy pcv is one of the disorders within the pachychoroid. Idiopathic polypoidal choroidal vasculopathy ipcv also described as posterior uveal bleeding syndrome or multiple serosanquinous retinal pigment rpe detachment syndrome is characterized by a branching choroidal vascular network and polypoidal vascular dilatations at the end of the network. Characteristics and racial variations of polypoidal. Polypoidal choroidal vasculopathy with an appearance similar to. En face ss oct demonstrated choroidal vascular abnormalities in 7 out of 7 eyes with pcv, and in 2 out of 3 enrolled fellow eyes in patients with unilateral pcv.
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