title: Association of lesion size and visual prognosis to polypoidal choroidal vasculopathy.
abstract: OBJECTIVE
  To investigate the progression of vascular lesions of polypoidal choroidal vasculopathy (PCV) as viewed with indocyanine green angiography and the visual prognosis of these eyes.
  
  
  METHODS
  Retrospective case study.
  
  
  METHODS
  We reviewed retrospectively the medical records of 88 consecutive patients (88 eyes) with PCV who had been examined with indocyanine green angiography for more than 2 years.
  
  
  RESULTS
  Depending on the initial area of the vascular lesion, eyes were divided into smaller PCV (baseline area of lesion being < 1 disc area [DA], n = 22) and larger PCV (baseline area of lesion being ≥ 1 DA, n = 66). In larger PCV, the mean area of the lesion progressed significantly from 6.49 ± 8.96 mm(2) to 16.27 ± 14.19 mm(2) (P < .0001) with marked deterioration of visual acuity (P < .0001) during follow-up. In contrast, smaller PCV often showed minimal progression of the lesion, only limited exudative change, and the eyes maintained their initially good vision to the final visit. Smaller PCV lesions rarely progressed to extensive PCV lesions. Severe vision-threatening complications (ie, suprachoroidal hemorrhage, vitreous hemorrhage, and tears of the retinal pigment epithelium) were seen only in eyes with larger PCV, and in studying single nucleotide polymorphisms A69S of ARMS2 genes, there was a significant difference in T allele frequency between individuals with smaller PCV and those with larger PCV (20.2% vs 79.8%; P = .0235).
  
  
  CONCLUSIONS
  PCV with small vascular lesions shows minimal progression and no vision-threatening complications, and these eyes often maintain good visual acuity for a long time.
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan. tujikawa@kuhp.kyoto-u.ac.jp
authors: Akitaka
authors: A
authors: Tsujikawa
authors: Yumiko
authors: Y
authors: Ojima
authors: Kenji
authors: K
authors: Yamashiro
authors: Isao
authors: I
authors: Nakata
authors: Sotaro
authors: S
authors: Ooto
authors: Hiroshi
authors: H
authors: Tamura
authors: Hideo
authors: H
authors: Nakanishi
authors: Hisako
authors: H
authors: Hayashi
authors: Atsushi
authors: A
authors: Otani
authors: Nagahisa
authors: N
authors: Yoshimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D011506:Proteins / Q000235:genetics; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*
chemical_list: C514392:ARMS2 protein, human; D011506:Proteins; D007208:Indocyanine Green