POLYPOIDAL CHOROIDAL VASCULOPATHY PATTERN IN AGE-RELATED MACULAR DEGENERATION: A Clinicopathologic Correlation

LAFAUT, BART A.; Aisenbrey, Sabine; BROECKE, CAROLINE VAN DEN; Bartz-Schmidt, Karl-Ulrich; Heimann, Klaus

doi:10.1097/00006982-200006000-00011

Cited by 50 publications

(80 citation statements)

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“…This would then be compatible with the reported location of the PCV network and polyps. [20][21][22][23][24] Because we were interested in the differences in the components of the vascular structures after different types of treatments, we also reviewed the images of eyes that had been treated with anti-VEGF therapy. In a pilot case review, we found that the fine vascular network usually persisted without any evidence of regression in patients treated by anti-VEGF therapy, which is consistent with a recent report.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Oishi

Mandai

Kimakura

et al. 2011

Eye

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Objective To characterize an irregular capillary-like structure in the vascular network of eyes with polypoidal choroidal vasculopathy (PCV), and to determine whether its presence after photodynamic therapy (PDT) can be used to predict the clinical course of PCV. Methods We reviewed the clinical records of 29 eyes of 29 patients with PCV, who underwent PDT and confocal retinal angiographic examinations every 3 months. The images obtained before the PDT were compared with those after the PDT. The correlations between angiography findings and recurrences were evaluated. Results An area of fine, densely packed capillary-like vessels, named the fine vascular network, was identified within the polypoidal vascular network in 25 of 29 cases at the initial examination. The fine vascular network regressed in 23 cases (92%) after the first PDT. Thereafter, the fine vascular network remained or enlarged in 19 eyes, and 17 (84.5%) of these eyes had a recurrence of the polypoidal lesions or had exudative changes. In contrast, recurrences were found in only 2 of 10 (20%) eyes, whose fine network had regressed without a subsequent enlargement (Po0.001 compared with the former group). Conclusions A fine irregular vascular network is present in the majority of eyes with PCV before PDT. Its presence or expansion after PDT was significantly associated with a recurrence of PCV. Thus, we recommend that this network be monitored after treatment to determine whether a polypoidal vascular network will recur.

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Section: Discussionmentioning

confidence: 99%

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Oishi

Mandai

Kimakura

et al. 2011

Eye

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“…Previous reports, including one of describing the histopathologic changes of the PCV, 10 have emphasized the peripapillary location of the polypoidal lesions and suppose a peripapillary choroidal origin of the vascular abnormalities. 1,2,4 More recent studies showed that polypoidal lesions can be identified, apart from the peripapillary area, in the macula or less frequently in the periphery of the fundus.…”

Section: Discussionmentioning

confidence: 99%

“…[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).…”

Section: Introductionmentioning

confidence: 99%

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

Ladas¹,

Rouvas²,

Moschos

et al. 2004

Eye

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Purpose To study the prevalence, the clinical features, and the visual prognosis without treatment of polypoidal choroidal vasculopathy (PCV) in a large series of Greek patients presenting with exudative maculopathy. Methods The medical records, photographs, as well as fluorescein and indocyanine green (ICG) angiograms of a series of 268 consecutive elderly white Greek patients, who were originally diagnosed as having exudative age-related macular degeneration (AMD) were reviewed retrospectively. Results In all, 22 of the 268 (8.2%) patients initially suspected of having AMD were ultimately diagnosed with PCV. In 15 of the 22 (68.2%) patients with PCV, the polypoidal lesions were located in the peripapillary area. Large soft drusen were present in only two fellow eyes of the 10 (20%) patients with unilateral PCV compared with 120 fellow eyes of the 148 (81.1%) patients with unilateral AMD. At the last examination, 11 of the 22 (50%) patients with PCV and 120 of the 246 (48.8%) patients with AMD presented a visual acuity of less than 6/60 in at least one eye due to scar formation in the macula. Conclusions PCV is not an infrequent disease in Greece. A measurable number of Greek patients with findings suggestive of exudative AMD will instead have PCV. ICG angiography is important in differentiating between these two clinical entities. In Greeks, polypoidal lesions are predominately peripapillary and are not usually associated with macular drusen in the fellow eye. PCV and exudative AMD do not differ significantly in terms of their natural course and visual prognosis in Greek patients.

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“…[1][2][3] Subsequently, however, based on histological specimens and OCT examinations, PCV is considered to be a unique form of CNV. 25,26 In general, presumed exudative AMD is diagnosed as PCV when IA shows polypoidal lesions at the terminus of the branching vascular network. 8 In PCV, IA is essential to make the diagnosis and to precisely evaluate the entire vascular lesion.…”

Section: Discussionmentioning

confidence: 99%

Development of polypoidal lesions in age-related macular degeneration

Tsujikawa

Ojima

Yamashiro

et al. 2011

Eye

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Purpose To investigate the development of polypoidal lesions using indocyanine green angiography (IA) in eyes with typical age-related macular degeneration (AMD). Methods We retrospectively reviewed the medical records of 47 consecutive patients (47 eyes) with typical AMD who had been followed up with IA for at least 2 years. Results At the initial visit, although all eyes showed classic and/or occult choroidal neovascularization (CNV) associated with AMD, no eyes showed polypoidal lesions by IA. However, during follow-up, 13 (27.7%) of the 47 eyes did show polypoidal lesions. All polypoidal lesions developed at the edge of persistent CNV or, more often, at the terminus of recently progressed CNV. Of 12 eyes with a final lesion area 48 disc area, 7 (58.3%) showed newly developed polypoidal lesions. In the eyes with these newly developed polypoidal lesions, the mean area of the vascular lesion had extended significantly from 10.50±7.88 mm 2 to 20.87±10.21 mm 2 during follow-up (P ¼ 0.0018). Conclusion The current observation suggests that IA of active AMD sometimes reveals polypoidal lesions if there is progression of the CNV in the subretinal pigment epithelium space.

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POLYPOIDAL CHOROIDAL VASCULOPATHY PATTERN IN AGE-RELATED MACULAR DEGENERATION: A Clinicopathologic Correlation

Cited by 50 publications

References 0 publications

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

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

Development of polypoidal lesions in age-related macular degeneration

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