The fundoscopic features for differentiation between polypoidal choroidal vasculopathy and choroidal
Atchara Ampornpruet1, Paisan Ruamviboonsuk, Sittika Kokekhuntod
1Department of Ophthalmology, Rajavithi Hospital, Bangkok 10400, Thailand.
Objectives:
To evaluate the fundus features that can differentiate polypoidal choroidal vasculopathy (PCV) from choroidal neovascularization (CNV) due to age-related macular degeneration (AMD).
Design:
Retrospective, case-control study.
Material And Method:
The fundoscopic features of AMD-related CNV and PCV were compared for evaluation of relative risks for PCV. The odds ratio, sensitivity and specificity of each feature were also calculated.
Results:
A total of 30 patients, 15 PCV and 15 age-matched non-PCV cases, approved by indocyanine green angiography (ICG), were enrolled. The odds ratio is highest for subretinal polyp-like structure and lowest in scar formation (28 and 0, respectively) and these ratios are statistically significant differences (p = 0.001 and 0.032 respectively). The ratio for either circinate exudates, or larger than 4-disc area of subretinal fluid, or retinal pigment epithelial detachment is 1.75. The ratio for peripapillary location is 1.63. Subretinal membrane has a ratio of 1 while subretinal hemorrhage and subretinal fibrin have less than 1; they are 0.31 and 0.23 respectively. All these ratios are not statistically significant differences (p > 0.05).
Conclusion:
The orange polyp-like structures beneath retina are hallmarks for diagnosis of PCV. The "serosanguineous retinopathy", described as serous retinal deatchment or retinal pigment epithelial detachment with circinate exudates with or without subretinal hemorrhage at the posterior pole or peripapillary region, may also suggest the condition.
