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Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients.

Anantharaman G, Ramkumar G, Gopalakrishnan M, Rajput A - Indian J Ophthalmol (2010 Sep-Oct)

Bottom Line: Demographic data, clinical features and results of treatment were analyzed.Subgroup analysis of visual outcome following various modalities of treatment showed that the results of PDT (P < 0.001) and thermal laser (P < 0.001) were statistically significant.Thermal laser and PDT were safe and effective.

View Article: PubMed Central - PubMed

Affiliation: Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, India.

ABSTRACT

Aims: To present the clinical, indocyanine green angiography (ICGA) features and results of treatment for polypoidal choroidal vasculopathy (PCV) in Indian patients by a retrospective chart review.

Materials and methods: Forty five patients with PCV underwent complete ocular examination, fluorescein angiography (FFA) and ICGA. Treatment was advised for patients with macular involvement and progressive loss of visual acuity. Demographic data, clinical features and results of treatment were analyzed.

Results: Mean age at presentation was 61.06 years. Mean follow up was 18 months. The disease was more prevalent in males. Forty three patients had unilateral disease. The most common location of polyps in ICGA was subfoveal (42.5%). Exudative form was seen in 34 of the 47 eyes and the remaining 13 eyes had a hemorrhagic presentation. Thirty four eyes underwent treatment which included thermal laser (n = 11), photodynamic therapy (PDT) (n = 11) and transpupillary thermo therapy (TTT) (n = 12). Statistical analysis was done using the Chi-square test. Subgroup analysis of visual outcome following various modalities of treatment showed that the results of PDT (P < 0.001) and thermal laser (P < 0.001) were statistically significant.

Conclusions: PCV is an important differential diagnosis in patients presenting with serosanginous maculopathy and submacular hemorrhage. The disease was more prevalent in males and was unilateral in the Indian population. Timely intervention in cases with symptomatic polyps could achieve stabilization of visual acuity. Thermal laser and PDT were safe and effective.

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(A) Exudative pattern with extensive intraretinal lipid deposits in the macula. (B) Hemorrhagic pattern with large subretinal hemorrhage extending to the centre of the macula
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Figure 0001: (A) Exudative pattern with extensive intraretinal lipid deposits in the macula. (B) Hemorrhagic pattern with large subretinal hemorrhage extending to the centre of the macula

Mentions: The most common clinical presentation was a gradual loss of vision in 32/45 patients (70%) with a mean duration of 3.69 months. (1–12 months). The remaining 13 persons presented with sudden loss of vision with a mean duration of 5.7 days (1–14 days). Mean size of lesion on presentation was 4.56 disk diameters (1–10 disk diameter). Exudative pattern [Fig. 1A] was seen in 34 eyes while the remaining 13 eyes had a predominantly hemorrhagic form [Fig. 1B]. Serous macular detachment and serous PED were the most common clinical findings in the macula. Six eyes with hemorrhagic pattern had associated intraretinal lipid deposits.


Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients.

Anantharaman G, Ramkumar G, Gopalakrishnan M, Rajput A - Indian J Ophthalmol (2010 Sep-Oct)

(A) Exudative pattern with extensive intraretinal lipid deposits in the macula. (B) Hemorrhagic pattern with large subretinal hemorrhage extending to the centre of the macula
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992915&req=5

Figure 0001: (A) Exudative pattern with extensive intraretinal lipid deposits in the macula. (B) Hemorrhagic pattern with large subretinal hemorrhage extending to the centre of the macula
Mentions: The most common clinical presentation was a gradual loss of vision in 32/45 patients (70%) with a mean duration of 3.69 months. (1–12 months). The remaining 13 persons presented with sudden loss of vision with a mean duration of 5.7 days (1–14 days). Mean size of lesion on presentation was 4.56 disk diameters (1–10 disk diameter). Exudative pattern [Fig. 1A] was seen in 34 eyes while the remaining 13 eyes had a predominantly hemorrhagic form [Fig. 1B]. Serous macular detachment and serous PED were the most common clinical findings in the macula. Six eyes with hemorrhagic pattern had associated intraretinal lipid deposits.

Bottom Line: Demographic data, clinical features and results of treatment were analyzed.Subgroup analysis of visual outcome following various modalities of treatment showed that the results of PDT (P < 0.001) and thermal laser (P < 0.001) were statistically significant.Thermal laser and PDT were safe and effective.

View Article: PubMed Central - PubMed

Affiliation: Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, India.

ABSTRACT

Aims: To present the clinical, indocyanine green angiography (ICGA) features and results of treatment for polypoidal choroidal vasculopathy (PCV) in Indian patients by a retrospective chart review.

Materials and methods: Forty five patients with PCV underwent complete ocular examination, fluorescein angiography (FFA) and ICGA. Treatment was advised for patients with macular involvement and progressive loss of visual acuity. Demographic data, clinical features and results of treatment were analyzed.

Results: Mean age at presentation was 61.06 years. Mean follow up was 18 months. The disease was more prevalent in males. Forty three patients had unilateral disease. The most common location of polyps in ICGA was subfoveal (42.5%). Exudative form was seen in 34 of the 47 eyes and the remaining 13 eyes had a hemorrhagic presentation. Thirty four eyes underwent treatment which included thermal laser (n = 11), photodynamic therapy (PDT) (n = 11) and transpupillary thermo therapy (TTT) (n = 12). Statistical analysis was done using the Chi-square test. Subgroup analysis of visual outcome following various modalities of treatment showed that the results of PDT (P < 0.001) and thermal laser (P < 0.001) were statistically significant.

Conclusions: PCV is an important differential diagnosis in patients presenting with serosanginous maculopathy and submacular hemorrhage. The disease was more prevalent in males and was unilateral in the Indian population. Timely intervention in cases with symptomatic polyps could achieve stabilization of visual acuity. Thermal laser and PDT were safe and effective.

Show MeSH
Related in: MedlinePlus