title: Toward a specific classification of polypoidal choroidal vasculopathy: idiopathic disease or subtype of age-related macular degeneration.
abstract: OBJECTIVE
  To suggest a clinical distinction between idiopathic polypoidal choroidal vasculopathy (PCV) and secondary polyps associated with neovascular age-related macular degeneration (NV-AMD).
  
  
  METHODS
  The study was a retrospective case series of 52 eyes of 52 consecutive patients (31 females and 21 males) diagnosed with PCV. Initial diagnosis was based on scanning laser ophthalmoscope-indocyanine green angiography (SLO-ICGA) in association with fluorescein angiography (FA) and optical coherence tomography (OCT). All the data and images were analyzed in a masked fashion by four experienced examiners in two different sessions: the first, to classify patients into the two hypothesized groups (idiopathic polyps or NV-AMD-related polyps); the second, following a predetermined scheme, to describe objective features. The results obtained in each session underwent a cross multivariate analysis to identify statistically significant differences (P ≤ 0.05) between the two groups.
  
  
  RESULTS
  The two groups were clinically different on the basis of FA (leakage origin [P = 0.001] and presence of drusen [P = 0.001]), ICGA (evidence of choroidal neovascularization [CNV; P = 0.001] and/or branching vascular network [BVN; P = 0.001]), OCT imaging (type of pigmented epithelium detachment [P = 0.001], presence of BVN [P = 0.001], and subfoveal choroidal thickness [P = 0.001]). Further significant differences were observed according to the location of lesion (uni- or multifocal) (P = 0.001), type of CNV (P = 0.001), and best-corrected visual acuity (P = 0.001).
  
  
  CONCLUSIONS
  Our study demonstrated clinical and statistically significant differences between idiopathic PCV and NV-AMD-related polyps that could be considered as distinct entities. Although they share some similarities, mainly the sub-RPE location, the ability to identify a specific clinical pattern suggests a more specific therapeutic approach for these two entities.
authors.affiliation: Department of Ophthalmology Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France 2Centre de l'Odéon, Paris, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coscas
authors.affiliation: Centre de l'Odéon, Paris, France 3Eye Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Lupidi
authors.affiliation: Department of Ophthalmology Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France 2Centre de l'Odéon, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Coscas
authors.affiliation: Department of Ophthalmology Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Fayçal
authors.initials: F
authors.lastname: Benjelloun
authors.affiliation: Department of Ophthalmology Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zerbib
authors.affiliation: Saint-Joseph University, Faculty of Medicine, Beirut, Lebanon.
authors.forename: Ali
authors.initials: A
authors.lastname: Dirani
authors.affiliation: Department of Ophthalmology Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Oudy
authors.initials: O
authors.lastname: Semoun
authors.affiliation: Department of Ophthalmology Centre Hospitalier Intercommunal de Créteil, University Paris Est, Créteil, France.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D020256:Choroidal Neovascularization / Q000145:classification* / Q000175:diagnosis; D004396:Coloring Agents; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009887:Ophthalmoscopy; D011127:Polyps / Q000145:classification* / Q000175:diagnosis; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D057135:Wet Macular Degeneration / Q000145:classification* / Q000175:diagnosis
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green