Polypoidal choroidal vasculopathy in white patients
Stephen J Davis1, Andreas K Lauer, Christina J Flaxel
1Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
Retina (Philadelphia, Pa.)
|July 1, 2014
Summary
Polypoidal choroidal vasculopathy (PCV) can mimic age-related macular degeneration in white patients. Early diagnosis and photodynamic therapy significantly improve or maintain vision while reducing anti-VEGF injection frequency.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Medical Research
Background:
- Polypoidal choroidal vasculopathy (PCV) is a subtype of exudative age-related macular degeneration.
- PCV diagnosis and management in white populations require further elucidation.
- Distinguishing PCV from typical AMD is crucial for effective treatment.
Purpose of the Study:
- To describe a cohort of white patients diagnosed with PCV in the United States.
- To highlight diagnostic challenges and treatment outcomes for PCV in this demographic.
Main Methods:
- Retrospective chart review of 27 white patients with PCV at a single institution.
- Analysis of presenting symptoms, diagnostic timelines, and treatment modalities.
Main Results:
- The average age of patients was 74.3 years, with 48% males.
- Common misdiagnosis was exudative AMD, with a mean diagnostic delay of 17.5 months.
- Photodynamic therapy (PDT) led to fluid reduction in 86%, with 41% experiencing vision improvement and 36% maintaining stable vision.
- Post-PDT, anti-VEGF injection frequency decreased by 67%.
Conclusions:
- PCV can present as recalcitrant exudative AMD in white patients, underscoring diagnostic importance.
- Temporal or peripapillary location and presence of lipid were common findings.
- PDT followed by anti-VEGF therapy improved or maintained vision in 77% of patients, reducing treatment burden.
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