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POLYPOIDAL CHOROIDAL VASCULOPATHY: A CLINICOPATHOLOGIC STUDY.

Kareem Moussa1, Michele M Bloomer, Daniel M Schwartz

  • 1*Department of Ophthalmology, University of California, San Francisco, San Francisco, California; †Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California; and ‡Department of Ophthalmology, Santa Clara Valley Medical Center, San Jose, California.

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Summary
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Polypoidal choroidal vasculopathy can mimic an intraocular mass, causing sudden vision loss. Early diagnosis in East Asian patients with vitreous hemorrhage is crucial.

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Area of Science:

  • Ophthalmology
  • Medical Research

Background:

  • Polypoidal choroidal vasculopathy (PCV) is a subtype of age-related macular degeneration.
  • PCV can present with varied clinical manifestations, sometimes mimicking other ocular pathologies.

Observation:

  • A 58-year-old Vietnamese male presented with a blind, painful eye and suspected intraocular mass.
  • B-scan ultrasonography revealed massive intraocular hemorrhage, precluding definitive diagnosis of a tumor.
  • Histopathologic examination post-enucleation confirmed polypoidal choroidal vasculopathy.

Findings:

  • Polypoidal choroidal vasculopathy can present as a blind, painful eye with massive vitreous hemorrhage.
  • The condition can be misdiagnosed as an intraocular mass due to extensive hemorrhage.
  • Histopathology is essential for confirming PCV in atypical presentations.

Implications:

  • PCV should be considered in the differential diagnosis of intraocular masses, especially in patients of East Asian descent.
  • Rapid progression and irreversible vision loss underscore the importance of timely diagnosis and management.
  • This case highlights the need for high clinical suspicion for PCV in patients with unexplained vitreous hemorrhage.