Optical Coherence Tomography Angiography of Idiopathic Polypoidal Choroidal Vasculopathy

To analyze the morphological characteristics of polypoidal choroidal vasculopathy (PCV) on optical coherence tomography angiography (OCT-A).

Consecutive patients with PCV underwent complete ophthalmological examination, including fundus photography, fluorescein angiography, indocyanine green angiography, spectral-domain OCT and OCT-A.

Segmentation of the choriocapillaris layer on OCT-A revealed the branching vascular network as a hyper-flow lesion, and it revealed the polypoidal lesion as a hyper-flow round structure surrounded by a hypo-intense halo in some cases and as a hypo-flow round structure in most cases.

OCT-A is a noninvasive imaging modality that allows for the visualization of different structures in PCV. The branching vascular network is consistently and clearly detected. The hypo-flow round appearance of the polyps on OCT-A is probably due to unusual blood flow inside of the polypoidal lesions, in contrast with the branching vascular network. Further improvements in OCT-A knowledge will provide information on the specificity of the different intensity characteristics in PCV.