Polypoidal choroidal vasculopathy in white patients

Retina. 2014 Nov;34(11):2185-91. doi: 10.1097/IAE.0000000000000206.

Abstract

Purpose: To report on a series of white patients in the United States with polypoidal choroidal vasculopathy (PCV).

Methods: This is a retrospective chart review of 27 patients at a single center with PCV.

Results: The mean age was 74.3 with 48% being male. The most common presenting diagnosis was exudative age-related macular degeneration in 59%, and it took 17.5 months to diagnose PCV. During this time, patients received one antivascular endothelial growth factor injection every 1.3 months. The most common reason for suspecting PCV was a large retinal pigment epithelial detachment or a poor response to antivascular endothelial growth factor therapy. Once PCV was diagnosed, most underwent photodynamic therapy. In those who received photodynamic therapy, the fluid and/or age-related macular degeneration decreased in 86%. The vision improved in 41% with 36% maintaining stable vision. Patients received only one additional injection every 3.95 months after photodynamic therapy.

Conclusion: This is one of the larger series of PCV in an entirely white population. It emphasizes the importance of diagnosis in whites as PCV can masquerade as recalcitrant exudative age-related macular degeneration. Common findings were a temporal or peripapillary location and the presence of lipid. After photodynamic therapy, the patients still required antivascular endothelial growth factor therapy, but the injection burden was decreased by 67% and vision was found to be improved or maintained in 77% of patients.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use
  • Choroid Diseases* / diagnosis
  • Choroid Diseases* / drug therapy
  • Choroid Diseases* / pathology
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases* / diagnosis
  • Peripheral Vascular Diseases* / drug therapy
  • Peripheral Vascular Diseases* / pathology
  • Photochemotherapy / methods
  • Photosensitizing Agents / therapeutic use
  • Retrospective Studies
  • United States
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Photosensitizing Agents
  • Vascular Endothelial Growth Factor A