Polypoidal choroidal vasculopathy with choroidal vascular hyperpermeability.
OBJECTIVE
To describe the incidence and clinical characteristics of polypoidal choroidal vasculopathy (PCV) associated with choroidal vascular hyperpermeability.


METHODS
Retrospective observational case series.


METHODS
We reviewed the medical records of 122 consecutive eyes with PCV and 106 consecutive eyes with exudative age-related macular degeneration (AMD). Fluorescein angiography and indocyanine green (ICG) angiography were performed using a confocal scanning laser system. In the midphase of ICG angiography, we evaluated choroidal vascular hyperpermeability, which is recognized as one of the characteristic findings in central serous chorioretinopathy (CSC). Choroidal vascular hyperpermeability appeared as multifocal patchy areas of hyperfluorescence with blurred margins within the choroid that increased in intensity with time after injection of the dye.


RESULTS
Of 122 eyes with PCV, 12 (9.8%) eyes of 10 patients exhibited multifocal choroidal hyperfluorescence in the midphase of ICG angiography, whereas two (1.9%) of 106 eyes with exudative AMD showed a similar appearance (P = .013). Of the 12 eyes in 10 patients with PCV that demonstrated multifocal choroidal hyperfluorescence, we also noted that the early phase of ICG angiography showed choroidal filling delay in seven eyes (58%) and venous dilation in 12 eyes (100%). Four of these 12 eyes (33%) had a medical history of CSC, and nine (90%) of the 10 patients revealed multifocal choroidal hyperfluorescence bilaterally.


CONCLUSIONS
Multifocal choroidal hyperfluorescence seen by ICG angiography occurs more frequently in eyes with PCV than in those with AMD. Choroidal vascular hyperpermeability, reportedly a characteristic finding in CSC, might be one of the risk factors of PCV.
Sasahara
Manabu
M
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. sasahara@kuhp.kyoto-u.ac.jp
Tsujikawa
Akitaka
A
Musashi
Kunihiro
K
Gotoh
Norimoto
N
Otani
Atsushi
A
Mandai
Michiko
M
Yoshimura
Nagahisa
N
D000368:Aged; D000369:Aged, 80 and over; D002199:Capillary Permeability; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000150:complications* / Q000175:diagnosis; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000175:diagnosis; D012164:Retinal Diseases / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green