Nasal and independent polypoidal lesions in polypoidal choroidal vasculopathy
Akiko Okubo1, Noriko Abematsu, Taiji Sakamoto
1Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. akiko@m2.kufm.kagoshima-u.ac.jp
Background:
Polypoidal vessels in polypoidal choroidal vasculopathy (PCV) are known to occur frequently in the macular and peripapillary regions. The aim of this study is to describe patients with polypoidal vessels that are nasal to the optic disc, being independent of macular polypoidal lesions.
Methods:
A 75-year-old man and a 65-year-old man with polypoidal vessels in the macula of both eyes were followed up through routine examinations including indocyanine green angiography and optical coherence tomography.
Results:
A polypoidal vessel located 1.5 disc diameters to the nasal margin of the disc was found in the right eye during the first examination in one case, and in the other case it developed during the follow-up period, after successful treatment using photodynamic therapy for the polypoidal lesion in the macula of the left eye. Indocyanine green angiography disclosed no continuity between the polypoidal vessels nasal to the disc and the polypoidal vessels in the macula region in either case. The nasal polypoidal vessels were not associated with exudative changes in either case, and the vessel in one case disappeared spontaneously without any treatment.
Conclusions:
The findings of this study demonstrate that PCV could involve regions outside the macula and occur in multiple areas independently. The results also indicate the dynamic nature and transitory appearance of polypoidal vessels. Polypoidal vessels nasal to the disc might be overlooked, especially in cases that are not associated with exudative changes, and careful examination might disclose more subclinical nasal polypoidal vessels. Further detailed examination would be helpful to gain a better understanding of the pathogenesis of PCV.
