Abstract
Purpose To report the clinical findings, angiographic results, clinical course, response to laser photocoagulation and systemic associations in a group of patients with idiopathic polypoidal choroidal vasculopathy (IPCV).
Methods All patients with IPCV attending the macular clinic underwent a complete ocular examination, and fluorescein and indocyanine green angiography. In addition, a systemic examination including blood pressure, full blood count, plasma viscosity and coagulation status of patients was carried out.
Results We present a series of 5 patients (7 eyes) with clinical and angiographic evidence of IPCV with follow-up of 3-6 years. We report diverse demographic and clinical manifestations. One patient had polypoidal lesions found at the peripheral retina (anterior to equator) of both eyes. Three patients were treated with laser photocoagulation and achieved stable vision; 2 patients who had no laser treatment experienced deteriorated vision, one of whom had a vitrectomy. One patient was hypertensive, 2 patients were found to have raised plasma viscosity, and 1 patient had thrombocytopenia.
Conclusions The clinical spectrum of IPCV is wider than previously documented. It is a distinct clinical entity which should be differentiated from other forms of haemorrhagic and exudative maculopathy. The availability of indocyanine green angiography has allowed increased recognition of these cases. Early selective laser treatment on lesions affecting maculae could stabilise the disease. Its association with systemic cardiovascular disease and blood disorder may predispose to the recurrence of haemorrhagic events in this entity.
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Yannuzzi LA, Sorenso J, Spaide RF, Lipson B . Idiopathic polypoidal choroidal vasculopathy. Retina 1990;10:1–8.
Spaide RF, Yannuzzi LA, Slakter JS, Sorenso JA, Orlock DA . Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina 1995;15:100–10.
Yannuzzi LA, Ciardella A, Spaide RF, Rabb M, Freund B, Orlock DA . The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol 1997;115:478–85.
Stern RM, Zakov N, Zegarra H, Gutman FA . Multiple recurrent serosanguineous retinal pigment epithelial detachments in black women. Am J Ophthalmol 1985;100:560–9.
Kleiner RC, Brucker AI, Johnston RL . The posterior uveal bleeding syndrome. Retina 1990;10:9–17.
Yannuzzi LA, Nogueira FB, Spaide RF, Guyer DR, Orlock DA, Colombero D, et al. Idiopathic polypoidal choroidal vasculopathy: a peripheral lesion [letter]. Arch Ophthalmol 1998;116:382–3.
Ross RD, Gitter KA, Cohen G, Schomaker KS . Idiopathic polypoidal choroidal vasculopathy associated with retinal macroaneurysm and hypertensive retinopathy. Retina 1996;16:105–11.
Ring HG, Fujino T . Observations on the anatomy and pathology of the choroidal vasculature. Arch Ophthalmol 1967;78:431–4.
Tso MOM, Jampol LM . Pathophysiology of hypertensive retinopathy. Ophthalmology 1982;93:60–73.
Iijima H, Imai M, Gohdo T, Tsukahara S . Optical coherence tomography of idiopathic polypoidal choroidal vasculopathy. Am J Ophthalmol 1999;127:301–5.
Yarnell JWG, Baker lA, Sweetnam PM, et al. Fibrinogen, viscosity and white blood cell count are major risk factors for ischaemic heart disease. The Caerphilly and Speedwell Collaboration Heart Disease Studies. Circulation 1991;83:836–44.
Moller L, Kristensen TS . Plasma fibrinogen and ischaemic heart disease risk factors. Arterioscleros Thromb 1991;11:344–50.
Friedman E, Smith TR, Kuwabara T, et al. Choroidal vascular patterns in hypertension. Arch Ophthalmol 1985;60:235–91.
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Presented as a poster at the Annual Conference of the Royal College of Ophthalmologists, 1998
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Lip, PL., Hope-Ross, M. & Gibson, J. Idiopathic polypoidal choroidal vasculopathy: A disease with diverse clinical spectrum and systemic associations. Eye 14, 695–700 (2000). https://doi.org/10.1038/eye.2000.186
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DOI: https://doi.org/10.1038/eye.2000.186
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