Pigment epithelial detachment in polypoidal choroidal vasculopathy

Area of Science:

• Ophthalmology
• Medical Imaging
• Choroidal Neovascularization

Background:

• Polypoidal choroidal vasculopathy (PCV) is a common subtype of neovascular age-related macular degeneration.
• Serosanguineous pigment epithelial detachments (PEDs) are a hallmark of PCV, often associated with polypoidal lesions.
• Understanding the morphological relationship between PEDs and polypoidal lesions is crucial for diagnosis and treatment.

Purpose of the Study:

• To investigate the morphological characteristics of serosanguineous PEDs with associated polypoidal lesions in PCV.
• To correlate findings from indocyanine green angiography (IA) and optical coherence tomography (OCT) in eyes with PCV.

Main Methods:

• Retrospective observational case series of 93 eyes from 85 patients with PCV.
• Analysis of lesions using indocyanine green angiography (IA) and optical coherence tomography (OCT).

Main Results:

• Serous or hemorrhagic PEDs were present in 55% of eyes (51/93).
• A notch in the PED, corresponding to polypoidal lesions, was observed in 53% of these eyes (27/51) via IA and 57% via OCT (29/51).
• Polypoidal lesions were located at the PED margin (65%), inside the PED (24%), and outside the PED (2%).

Conclusions:

• Polypoidal lesions are frequently located at the margin of PEDs, creating a visible notch.
• Fluid accumulation and exudate associated with polypoidal lesions can lead to detachment from the Bruch membrane, causing them to appear within the PED.