Polypoidal choroidal vasculopathy in tilted disk syndrome and high myopia with staphyloma.
OBJECTIVE
To describe polypoidal choroidal vasculopathy as a complication of tilted disk syndrome and high myopia with staphyloma.


METHODS
Retrospective interventional case series.


METHODS
This report was a multicenter evaluation of six patients (eight eyes) with tilted disk syndrome or high myopia that was complicated by posterior staphyloma. Complete ophthalmic examination that included fluorescein angiography, optical coherence tomography (OCT), and indocyanine green angiography (ICG-A) was performed in all patients.


RESULTS
All patients had macular abnormalities and visual loss. Fundus examination and fluorescein angiography showed typical features of tilted disk syndrome (five patients; six eyes) or high myopia (one patient; two eyes) with staphyloma that was associated with polypoidal choroidal vasculopathy. OCT and ICG-A confirmed the presence of polypoidal dilations in the choroid. Seven eyes were treated with laser photocoagulation or verteporfin-photodynamic therapy (V-PDT), although one eye did not require treatment. Visual acuity at the final visit had improved in three eyes, deteriorated in three eyes, and remained unchanged in two eyes.


CONCLUSIONS
Polypoidal choroidal vasculopathy is a potential cause of visual loss in tilted disk syndrome and high myopia. We postulate that choroidal abnormalities at the border of staphylomas induce blood-flow disturbances that are similar to those disturbances that are observed in chronic central serous chorioretinopathy, which is another condition that occasionally is associated with polypoidal choroidal vasculopathy. The pathogenesis remains unclear, and further study is required to better understand the formation of choroidal polypoidal dilations in these conditions.
Mauget-Faÿsse
Martine
M
Rabelais Ophthalmologic Center, Lyon, France. centrerabelais@wanadoo.fr
Cornut
Pierre-Loïc
PL
Quaranta El-Maftouhi
Maddalena
M
Leys
Anita
A
D000368:Aged; D002829:Choroid / Q000098:blood supply* / Q000473:pathology; D004396:Coloring Agents; D004108:Dilatation, Pathologic; D005124:Eye Abnormalities / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D009898:Optic Disk / Q000002:abnormalities*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010778:Photochemotherapy; D012189:Retrospective Studies; D015422:Scleral Diseases / Q000150:complications*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green