Punctate hyperfluorescent spots associated with polypoidal choroidal vasculopathy on indocyanine green angiography

To evaluate punctate hyperfluorescent spots on indocyanine green angiography (ICGA) in eyes with polypoidal choroidal vasculopathy (PCV).

Retrospective observation case series of 88 eyes of 81 patients (63 men and 18 women) analyzing fundus photography, fluorescein angiography, ICGA, and spectral-domain optical coherence tomography (OCT) findings at baseline.

Seven patients (9%) had bilateral PCV lesions. Mean age was 68.44 ± 5.94 years (range: 45 to 86 years). Macular-type PCV was found in 72 eyes (81.8%), peripapillary-type PCV in 12 eyes (13.6%), and combined-type PCV in four eyes (4.5%). Choroidal vascular hyperpermeability was observed in 38 eyes (43.2%), and punctate hyperfluorescent spots on ICGA in 47 eyes (53.4%). ICGA of unaffected fellow eyes of 74 patients with unilateral PCV revealed choroidal hyperpermeability in 23 eyes (31.1%) and punctate hyperfluorescent spots in 38 eyes (51.4%). Presence of punctate hyperfluorescent spots was significantly associated with choroidal vascular hyperpermeability (P < .001).

Punctate hyperfluorescent spots were frequently observed in eyes with PCV in late-phase ICGA, as previously described in eyes with central serous chorioretinopathy, which may represent leakage from punctate hyperpermeable inner choroid spots or late staining of forme fruste drusen or drusen-like subretinal pigment epithelium deposits associated with choroidal hyperpermeability.