Polypoidal Choroidal Vasculopathy

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Fundus Scan

What is Polypoidal Choroidal Vasculopathy?

Polypoidal Choroidal Vasculopathy (PCV) is a chronic eye disease where there is fluid leakage and bleeding from abnormal blood vessels of the retina and choroid on the inside back wall of the eye (Exudative Chorioretinopathy). It is thought to be a subtype of wet age-related macular degeneration (wet AMD), and is often characterised by a network of abnormal branching vessels and terminal balloon-like structures.

Polypoidal Choroidal Vasculopathy affects the macula, which is the central part of the retina, and may result in significant central vision loss.

Polypoidal Choroidal Vasculopathy Prevalence  varies from 0.4% to 10.6% of population, depending on ethnicity. In research studies, up to 50% of Asian patients with wet AMD have been found to have PCV.

What are the symptoms?

Some patients with Polypoidal Choroidal Vasculopathy may have good vision and no symptoms, especially patients with quiescent Polypoidal Choroidal Vasculopathy lesions. However, most of PCV patients have one or more of the symptoms listed below:

  • Blurred or dim vision
  • Distorted vision (e.g. straight objects appear to be wavy or crooked)
  • Floaters or partially diminished spots in the vision
  • Missing spots or shadows in the vision
  • Sudden loss of vision

Who is at Risk?

Polypoidal Choroidal Vasculopathy can occur in people aged between their 20s to 80s, but it is most commonly diagnosed between the ages of 50 and 70 years. Smoking is an important risk factor.

Polypoidal Choroidal Vasculopathy may be genetic and it is often recommended that patients who have been diagnosed with PCV have other family members tested for the same condition.

How is it Diagnosed?

Polypoidal Choroidal Vasculopathy is characterised by orange-reddish balloon-like lesions during clinical slit-lamp examination and on retinal fundus photography. However, it may be difficult to diagnose using these standard clinical techniques only. A Fluorescein Angiography (FFA) can help distinguish Polypoidal Choroidal Vasculopathy from other types of macular and retinal disorders. It is often difficult to see any particular features of PCV without the aid of advanced instruments such as the SPECTRALIS HRA + OCT (optical coherence tomography) and Indocyanine Green Angiography (ICG).

An OCT scan can accurately diagnose the presence of polypoidal lesions and determine whether the lesions are actively leaking or bleeding.

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OCT Scan

 

An ICG is the gold-standard for diagnosis of Polypoidal Choroidal Vasculopathy and it allows our Retina Specialists to determine individualisation of treatment methods and monitor treatment outcomes for our patients.

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ICG Scan

 

Can it be treated?

Patients with Polypoidal Choroidal Vasculopathy and no symptoms can be observed by our Retina Specialists with regular careful monitoring visits.

In patients with visual problems, a number of treatment methods can be applied and our Retina Specialists will discuss these treatments with each patient based on their eye condition. These treatment methods have been proven to be effective in helping to stabilise and/or improve vision, reduce or stop leaking from the vessels and lower macular edema in patients with PCV.

Treatments for PCV include:

  • ICG-guided Verteporfin Photodynamic Therapy (“Cold Laser”)
  • Intravitreal injections of Anti-VEGF medications (into the eye)
  • Thermal Laser Photocoagulation (“Hot Laser”)

Based on the results of a comprehensive eye examination, our Retina Specialists will determine which treatment(s) will be suitable for each patient’s eye condition. However, research has reported that PCV can recur in up to 60% of patients even after active treatment. Strathfield Retina Clinic is currently conducting research to investigate the effectiveness, safety and tolerability of different treatment methods on patients with PCV, to improve the health outcomes of these patients.