Clinicopathologic findings in polypoidal choroidal vasculopathy
Hiroyuki Nakashizuka1, Masako Mitsumata, Shigekuni Okisaka
1Department of Visual Science, Division of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.
Investigative Ophthalmology & Visual Science
|July 1, 2008
Summary
Polypoidal choroidal vasculopathy (PCV) is characterized by hyalinized choroidal vessels, similar to arteriosclerosis. Histopathology reveals fibrin and plasma exudation, with inflammatory cells present.
Area of Science:
- Ophthalmology
- Pathology
Background:
- Polypoidal choroidal vasculopathy (PCV) is a significant cause of vision loss.
- Understanding the histopathologic basis of PCV is crucial for developing effective treatments.
Observation:
- Histopathologic examination of PCV specimens revealed hyalinization of choroidal vessels.
- Massive exudation of fibrin and blood plasma was a consistent finding.
- In some cases, aberrant blood vessels were observed above the retinal pigment epithelium (RPE).
Findings:
- Immunohistochemistry showed CD68-positive cells around hyalinized vessels and HIF-1alpha positive inflammatory cells in the stroma.
- Endothelial discontinuity was noted with CD34 staining, and vascular endothelial cells were negative for VEGF.
- Absence of alpha-smooth muscle actin (alpha-SMA)-positive cells indicated a lack of smooth muscle differentiation in the PCV vessels.
Implications:
- The findings suggest that choroidal vessel hyalinization is a key feature of PCV pathogenesis, akin to arteriosclerosis.
- The presence of inflammatory cells and endothelial changes highlights the complex vascular remodeling in PCV.
- Further research into these histopathologic features may lead to novel therapeutic strategies for PCV.
