Polypoidal choroidal vasculopathy in Caucasians.

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Occult choroidal neovascularization (CNV) is a common finding in age-related macular degeneration (AMD).
• Polypoidal choroidal vasculopathy (PCV) is an important subtype of CNV, particularly in Asian populations.
• The prevalence and clinical characteristics of PCV in Caucasian patients with occult CNV require further elucidation.

Purpose of the Study:

• To determine the prevalence of PCV in Caucasian patients presenting with occult CNV.
• To describe the clinical spectrum and anatomical distribution of PCV lesions in this population.
• To evaluate the treatment outcomes of laser photocoagulation for PCV.

Main Methods:

• Indocyanine green angiography (ICGA) was used to diagnose PCV in 374 eyes of Caucasian patients (≥58 years) with occult CNV on fluorescein angiography (FA).
• Clinical findings (funduscopy, FA, ICGA) were analyzed in 36 PCV patients.
• Laser photocoagulation outcomes were assessed in 14 PCV eyes with at least 6 months of follow-up.

Main Results:

• PCV was diagnosed in 4% (14/374) of Caucasian eyes with occult CNV.
• Polypoidal lesions were located in the macula, peripapillary area, temporal vascular arcade, and mid-periphery.
• Successful regression of polyps after laser treatment was observed in 5/5 peripapillary lesions but only 5/9 macular or arcade lesions.

Conclusions:

• PCV is a notable finding in Caucasian patients with occult CNV, often presenting with overlapping features to typical AMD.
• The anatomical location of PCV lesions influences treatment prognosis.
• Laser photocoagulation offers a relatively good prognosis for peripapillary PCV but a more guarded outcome for macular and arcade lesions.