Polypoidal choroidal vasculopathy in Chinese patients

Abstract

Aims: To report the clinical features and outcomes of polypoidal choroidal vasculopathy (PCV) in Chinese patients with or without laser treatment. Methods: A consecutive series of 204 indocyanine green angiographies (ICGA) performed for patients with a provisional diagnosis of age related macular degeneration were reviewed retrospectively. Inclusion criteria were ICGA with angiographic features of PCV and patients of Chinese ethnic origin. Medical records were then reviewed and patients were recalled for further assessments. Results: 22 eyes of 19 patients (9.3%) were included. The mean follow up period was 27.4 months (range 4-60 months). The mean age of patients at presentation was 65.1 years (range 51-77 years). The commonest clinical feature at presentation was subretinal haemorrhage (63.6%), followed by retinal exudation (59.1%) and haemorrhagic pigment epithelial detachment (59.1%). There was a predominance of males (68.4%), unilaterality (84.2%), and macular location of polyps (63.6%). Nine eyes received laser photocoagulation. The median initial visual acuity for both the laser and non-laser groups was 6/18. Stable or improved vision was attained in 56% and 31% of laser and non-laser groups, respectively (Fisher's exact test, p=0.38). Mean loss of Snellen lines was 3.1 and 1.1 for the two groups, respectively (two sample t test, p=0.31). At the last follow up, 15 (68.2%) eyes had poor visual acuity of 6/60 or worse, mostly attributed to disciform scar or exudative maculopathy. Conclusions: There is a predominance of males, unilaterality, and macular location of polyps in Chinese patients with PCV. The overall visual prognosis is guarded regardless of treatment. There is a large amount of variation in the natural course of PCV among different ethnic groups.

Comparison of photodynamic therapy to transpupillary thermotherapy for polypoidal choroidal vasculopathy

“…[11][12][13] This is in contrast to other series with predominantly Caucasian populations in which 15-47% were men. 14,15 It has been reported that 36% (5/14) of eyes with PCV and not treated had a worsening of visual acuity by 42 lines after a follow-up period of at least 2 years.…”

Polypoidal choroidal vasculopathy and exudative age-related macular degeneration in Greek population

“…While in the past, some reports exclusively associated PCV with old black females patients, [1][2][3]5 recently it has also been identified in male patients, other races, and ethnic groups. 8,9,11,12,14,15 Curiously in Japanese and Chinese patients, PCV is evident more prevalent in men. 8,15 In our series of white Greek patients, the difference in sex prevalence between PCV and AMD was not statistically significant.…”

“…8,9,11,12,14,15 Curiously in Japanese and Chinese patients, PCV is evident more prevalent in men. 8,15 In our series of white Greek patients, the difference in sex prevalence between PCV and AMD was not statistically significant. Further, the frequency of PCV was almost the same in both sexes.…”

“…8 However, a guarded prognosis of PCV has been suggested for patients of other races and ethnic groups. 12,15 Accordingly, the natural course of PCV seems to be different in different races and ethnic groups. In our series, half of our Greek white patients with PCV presented a visual acuity of less than 6/60 in at least one eye due to hypertrophic subretinal scar formation in the macula (Figure 1).…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] While its pathogenesis remains unclear, it is generally thought to be an inner choroidal vascular abnormality characterized by two main components: (1) a peculiar network of fine branching vessels external to choriocapillaris and (2) multiple terminal aneurysmal dilations at the border of the vascular network. These vascular dilations are sometimes visible clinically as a reddish-orange spheroidal polypoidal lesions, particularly if they are large enough and there is sufficient atrophy of the overlying retinal pigment epithelium (RPE).…”