1. History
  2. Exam
  3. Photos
  4. Diagnosis
  5. Teaching Points
  6. Comments

Case 49 Teaching Points

  • Polypoidal choroidal vasculopathy was first described as a peculiar hemorrhagic disorder of the macula, characterized by recurrent subretinal and subretinal pigment epithelium bleeding in middle-aged black women
  • The primary abnormality involves the choroidal circulation, and the characteristic lesion is an inner choroidal vascular network of vessels ending in an aneurysmal bulge or outward projection, visible clinically as a reddish orange, spheroid, polyp-like structure
  • Indocyanine green angiography is often required for diagnosis
  • Individuals of African-American and Asian descent are more at-risk for developing polypoidal choroidal vasculopathy, as the disorder seems to preferentially affect pigmented individuals. However, it has been shown that patients of other racial backgrounds may also be afflicted. Polypoidal choroidal vasculopathy has been found to be present in about 8-13% of white patients with clinical appearance of exudative age-related macular degeneration.
  • The natural course of the disease often follows a remitting-relapsing course. Clinically, it is associated with chronic, multiple, recurrent serosanguineous detachments of the retinal pigment epithelium and neurosensory retina with long-term preservation of good vision.
  • Photodynamic treatment appears to be a promising alternative to conventional laser therapy

References

Ciardella AP, Donsoff IM, Huang SJ, Costa DL, Yannuzzi LA. Polypoidal choroidal vasculopathy. Surv Ophthalmol 2004;49(1):25-37.

Last Modified: Friday, 27-Jun-2008 12:36:28 EDT