Idiopathic polypoidal choroidal vasculopathy of the macula.
OBJECTIVE
The authors evaluated the clinical, fluorescein, and indocyanine green (ICG) angiographic characteristics of the macular variant of idiopathic polypoidal choroidal vasculopathy (IPCV).


METHODS
Observational case series.


METHODS
The records, photographs, and fluorescein and ICG angiograms of eight eyes of seven patients with IPCV lesions confined to the macula were reviewed.


METHODS
The visual acuity, fundus examination, fluorescein and ICG angiographic characteristics, and clinical course were compared.


RESULTS
All patients demonstrated polypoidal lesions arising from macular choroidal vessels on ICG angiography. One patient had bilateral lesions. These lesions appeared hyperfluorescent in the early phases of both fluorescein and ICG angiography. Late-phase leakage was seen in cases associated with subretinal fluid or exudate. None of these patients demonstrated polypoidal lesions arising from the peripapillary choroidal circulation or peripapillary choroidal neovascularization. Three eyes with polypoidal lesions that were associated with subretinal fluid and exudates were treated with photocoagulation. Five eyes were not treated. Final visual acuity ranged from 20/20 to hand motions. Severe visual loss was associated with vitreous and subretinal hemorrhage, but this resolved without permanent severe visual loss in several cases.


CONCLUSIONS
In the macular variant of IPCV, ICG and fluorescein angiography demonstrate characteristic macular polypoidal lesions without evidence of peripapillary lesions. The vascular origin of these polypoidal lesions appears to be the macular choroidal circulation. This is distinguished from classic IPCV, in which lesions appear to arise from the peripapillary choroidal circulation. Visual prognosis appears to be good, with most patients retaining visual acuity of 20/80 or better. If subretinal fluid or exudates reduce visual acuity, photocoagulation should be considered.
Moorthy
R S
RS
Department of Ophthalmology, Northwestern University Medical School, Chicago, IL 60611, USA.
Lyon
A T
AT
Rabb
M F
MF
Spaide
R F
RF
Yannuzzi
L A
LA
Jampol
L M
LM
D000368:Aged; D002199:Capillary Permeability; D002829:Choroid / Q000098:blood supply* / Q000473:pathology; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012166:Retinal Hemorrhage / Q000209:etiology; D014792:Visual Acuity; D014823:Vitreous Hemorrhage / Q000209:etiology
D007208:Indocyanine Green