Clinical and angiographic manifestations of the macular variant of Idiopathic Polypoidal Choroidal Vasculopathy (IPCV)

Purpose. To evaluate the clinical and angiographic characteristics of the macular variant of IPCV. To study the vascular origin of the macular polypoidal lesions. Methods. Retrospective review of the records and fluorescein and ICG angiograms of six patients with macular IPCV. Results. Six patients aged 45 to 72 years with macular IPCV were evaluated. All patients demonstrated polypoidal lesions arising from macular choroidal vessels on ICG angiography. These lesions appeared to fluoresce in the early phases of both fluorescein and ICG angiography. Late phase leakage was seen in cases associated with subretinal fluid or exudate. None of these patients demonstrated polypoidal lesions arising from the peripapillary choroidal circulation or peripapillary choroidal neovascularization. Polypoidal lesions associated with subretinal fluid or exudates involving the fovea were treated. Two patients were treated with two sessions of photocoagulation and four were not treated. Final visual acuity ranged from 20/20 to 20/100. Conclusion. In macular IPCV, ICG and fluorescein angiography demonstrate macular polypoidal lesions which arise from the macular choroidal circulation. Visual prognosis appears to be good with patients retaining visual acuity of 20/100 or better.