Pigment epithelial detachment in polypoidal choroidal vasculopathy.
OBJECTIVE
To study the morphological features of serosanguineous pigment epithelial detachments (PEDs) with accompanying polypoidal lesions in eyes with polypoidal choroidal vasculopathy (PCV).


METHODS
Retrospective observational case series.


METHODS
For this observational case study, we retrospectively reviewed 93 consecutive eyes of 85 patients with PCV. The lesions in eyes with PCV were examined with indocyanine green angiography (IA) and optical coherence tomography (OCT).


RESULTS
Of 93 eyes with PCV, 51 eyes (55%) had serous or hemorrhagic PEDs. Of these 51 eyes, a notch in the PED was found in 27 eyes (53%) by angiography, most of which showed polypoidal lesions by IA that corresponded in location to the notch observed by angiography. Polypoidal lesions were detected outside the PED in one eye (2%), at the margin of the PED in 33 eyes (65%), and inside the PED in 12 eyes (24%). OCT revealed that PED had a notch observed tomographically in 29 eyes (57%), most of which corresponded in location to polypoidal lesions seen by IA. In eight eyes, polypoidal lesions, which were adherent to the inner surface of the serous PED, appeared to be detached from the Bruch membrane and the choroid.


CONCLUSIONS
Polypoidal lesions are located at the margin of PED and make a notch in the accompanying PED that is visible by angiography and tomographically. When the polypoidal lesions have increased exudate, the fluid from the lesions infiltrates under the polypoidal lesions themselves, which results in the lesions detaching from the Bruch membrane and appearing to be located inside the PED.
Tsujikawa
Akitaka
A
Department of Ophthalmology, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan. tujikawa@kuhp.kyoto-u.ac.jp
Sasahara
Manabu
M
Otani
Atsushi
A
Gotoh
Norimoto
N
Kameda
Takanori
T
Iwama
Daisuke
D
Yodoi
Yuko
Y
Tamura
Hiroshi
H
Mandai
Michiko
M
Yoshimura
Nagahisa
N
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000175:diagnosis; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology*; D012166:Retinal Hemorrhage / Q000209:etiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence
D007208:Indocyanine Green