Idiopathic polypoidal choroidal vasculopathy of the macula

Ramana S. Moorthy, Alice T. Lyon*, Maurice F. Rabb, Richard F. Spaide, Lawrence A. Yannuzzi, Lee M. Jampol

*Corresponding author for this work

Research output: Contribution to journalArticle

132 Scopus citations

Abstract

Objective: The authors evaluated the clinical, fluorescein, and indocyanine green (ICG) angiographic characteristics of the macular variant of idiopathic polypoidal choroidal vasculopathy (IPCV). Design: Observational case series. Participants: The records, photographs, and fluorescein and ICG angiograms of eight eyes of seven patients with IPCV lesions confined to the macula were reviewed. Main Outcome Measures: The visual acuity, fundus examination, fluorescein and ICG angiographic characteristics, and clinical course were compared. Results: All patients demonstrated polypoidal lesions arising from macular choroidal vessels on ICG angiography. One patient had bilateral lesions. These lesions appeared hyperfluorescent 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. Three eyes with polypoidal lesions that were associated with subretinal fluid and exudates were treated with photocoagulation. Five eyes were not treated. Final visual acuity ranged from 20/20 to hand motions. Severe visual loss was associated with vitreous and subretinal hemorrhage, but this resolved without permanent severe visual loss in several cases. Conclusions: In the macular variant of IPCV, ICG and fluorescein angiography demonstrate characteristic macular polypoidal lesions without evidence of peripapillary lesions. The vascular origin of these polypoidal lesions appears to be the macular choroidal circulation. This is distinguished from classic IPCV, in which lesions appear to arise from the peripapillary choroidal circulation. Visual prognosis appears to be good, with most patients retaining visual acuity of 20/80 or better. If subretinal fluid or exudates reduce visual acuity, photocoagulation should be considered.

Original languageEnglish (US)
Pages (from-to)1380-1385
Number of pages6
JournalOphthalmology
Volume105
Issue number8
DOIs
StatePublished - Aug 1 1998

ASJC Scopus subject areas

  • Ophthalmology

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