Type 2 choroidal neovascularisation in polypoidal choroidal vasculopathy: a retrospective case series

Br J Ophthalmol. 2018 Nov;102(11):1570-1574. doi: 10.1136/bjophthalmol-2017-311518. Epub 2018 Feb 7.

Abstract

Background and objective: To demonstrate the coexistence of polypoidal choroidal vasculopathy (PCV) with type 2 neovascularisation (NV), we used multimodal imaging, including spectral-domain optical coherence tomography angiography (SD-OCTA), to identify both types of lesions in the same eye.

Study design: This retrospective case series reviewed patients with PCV diagnosed with indocyanine green angiography (ICGA), fluorescein angiography (FA), SD-OCT and SD-OCTA.

Results: 15 eyes of 14 patients were imaged and diagnosed with PCV by ICGA. ICGA identified polyps in all these eyes, while SD-OCTA imaging identified polypoidal lesions in only 11 (73%) of these eyes with PCV. Branching vascular networks (BVNs) were detected in 12 eyes (80%) by ICGA and SD-OCTA. Type 2 NV was detected in four eyes (27%) by FA and SD-OCTA. In these eyes, a combination of polyps, BVNs and type 2 NV were detected using FA, ICGA and SD-OCTA.

Conclusion: BVN and type 2 NV can coexist in the same PCV eye and communicate with each other. This suggests that polyps may represent a structural variant of neovascular tissue rather than a distinct pathogenic process in NV.

Keywords: Optical Coherence Tomography Angiography (OCTA); Polypoidal Choroidal Vasculopathy (PCV); neovascular Age-related Macular Degeneration (nAMD).

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Choroid / blood supply
  • Choroid Diseases / diagnostic imaging*
  • Choroidal Neovascularization / diagnostic imaging*
  • Coloring Agents / administration & dosage
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Indocyanine Green / administration & dosage
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Polyps / diagnostic imaging*
  • Retrospective Studies
  • Tomography, Optical Coherence*

Substances

  • Coloring Agents
  • Indocyanine Green