Idiopathic polypoidal choroidal vasculopathy: case report

In 1990, Yannuzzi et al. introduced a new clinical entity, "idiopathic polypoidal choroidal vasculopathy" (IPCV). There is now a more-widespread worldwide recognition of a higher prevalence and importance of this disorder. We report on the first case of IPCV in Taiwan to our knowledge. A 63-year-old Taiwanese man complained of blurred vision in his right eye for 6 months. The anterior segment and vitreous were normal except for mild nuclear cataract changes. Fundus examination of the right eye showed hard exudates and multiple reddish-orange subretinal lesions in the macula. Fundus examination of the left eye was normal. Fluorescein angiography of the right eye showed multiple hyperfluorescent granular lesions in the macula. Subretinal leakage and pooling of fluorescein were present in the temporal macula. Indocyanine green angiography disclosed multiple aneurysmal dilations at the terminals of branching vascular networks. A hyperfluorescent aneurysmal lesion corresponding to the reddish-orange nodule was observed ophthalmoscopically, and a granular lesion was observed in fluorescein angiography. Focal retinal photocoagulation was applied to the leakage area identified with fluorescein angiography. Two months after photocoagulation was performed, the subretinal fluid had gradually resolved, but a new leakage in the macula was demonstrated with fluorescein angiography. His best corrected vision in the right eye was stable.