Polypoidal choroidal vasculopathy: simultaneous indocyanine green angiography and eye-tracked spectral domain optical coherence tomography findings

Abstract

Purpose: To describe simultaneous scanning laser ophthalmoscope indocyanine green angiographic and eye-tracked spectral-domain optical coherence tomography findings in eyes with polypoidal choroidal vasculopathy (PCV).

Methods: Eighteen eyes of 18 patients with PCV because of a variety of different diagnoses were imaged with simultaneous scanning laser ophthalmoscope indocyanine green angiography and eye-tracked spectral-domain optical coherence tomography to localize the polyps and their associated vascular structures with respect to the retinal layers.

Results: Regardless of the underlying diagnosis, simultaneous scanning laser ophthalmoscope indocyanine green angiography and eye-tracked spectral-domain optical coherence tomography imaging localized the polypoidal structures of PCV to within larger Type 1 neovascular complexes occurring within or above Bruch membrane. In 8 eyes, PCV appeared to adhere to the undersurface of an elevated retinal pigment epithelial detachment. In 1 eye, a PCV lesion was detected within the neurosensory retina having apparently eroded through the overlying retinal pigment epithelium.

Conclusion: Simultaneous scanning laser ophthalmoscope indocyanine green angiography and eye-tracked spectral-domain optical coherence tomography demonstrate that a majority of PCV represents a variant of the Type 1 neovascular growth pattern, which can occur in a variety of different neovascularized maculopathies. Polypoidal choroidal vasculopathy lesions appear to originate from long-standing choroidal neovascularization, rather than from the choroidal vasculature itself. Given these observations, PCV would be more accurately described as a neovasculopathy rather than as a choroidal vasculopathy.