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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 62-year-old male with 20/30 vision (A) serosanguinous maculopathy (arrow) with subretinal hemorrhage (arrow). Note reddish orange elevation in the peripapillary region (arrow). (B and C) Early and late FFA shows a serous PED. Note blocked fluorescence in the inferior edge of the PED suggestive of a hemorrhage. (D and E) ICGA pictures showing saccular dilatations in the peripapillary region (arrow). (F) 12 months later clinical picture shows no change. (G) 36 months after the initial examination, fundus photograph shows less hemorrhage and fluid. (H and I) Repeat ICG however shows no change
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Figure 0002: (A 62-year-old male with 20/30 vision (A) serosanguinous maculopathy (arrow) with subretinal hemorrhage (arrow). Note reddish orange elevation in the peripapillary region (arrow). (B and C) Early and late FFA shows a serous PED. Note blocked fluorescence in the inferior edge of the PED suggestive of a hemorrhage. (D and E) ICGA pictures showing saccular dilatations in the peripapillary region (arrow). (F) 12 months later clinical picture shows no change. (G) 36 months after the initial examination, fundus photograph shows less hemorrhage and fluid. (H and I) Repeat ICG however shows no change

Mentions: Thirty four of 47 eyes which underwent treatment were eligible for analysis of treatment outcomes. Of the remaining 13 eyes, 4 had a visual acuity of 20/30 or better and therefore not subjected to any form of treatment. The natural course of these four patients was favorable and one of these patients has a follow up of 36 months with stable visual acuity and no intervention[Fig. 2]. In the two patients with bilateral disease, only one eye was treated as the fellow eye had advanced disease with very poor visual outcome. The remaining seven patients did not report for treatment. Pneumatic displacement was performed initially at the time of clinical presentation for submacular hemorrhage in six eyes.


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 62-year-old male with 20/30 vision (A) serosanguinous maculopathy (arrow) with subretinal hemorrhage (arrow). Note reddish orange elevation in the peripapillary region (arrow). (B and C) Early and late FFA shows a serous PED. Note blocked fluorescence in the inferior edge of the PED suggestive of a hemorrhage. (D and E) ICGA pictures showing saccular dilatations in the peripapillary region (arrow). (F) 12 months later clinical picture shows no change. (G) 36 months after the initial examination, fundus photograph shows less hemorrhage and fluid. (H and I) Repeat ICG however shows no change
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0002: (A 62-year-old male with 20/30 vision (A) serosanguinous maculopathy (arrow) with subretinal hemorrhage (arrow). Note reddish orange elevation in the peripapillary region (arrow). (B and C) Early and late FFA shows a serous PED. Note blocked fluorescence in the inferior edge of the PED suggestive of a hemorrhage. (D and E) ICGA pictures showing saccular dilatations in the peripapillary region (arrow). (F) 12 months later clinical picture shows no change. (G) 36 months after the initial examination, fundus photograph shows less hemorrhage and fluid. (H and I) Repeat ICG however shows no change
Mentions: Thirty four of 47 eyes which underwent treatment were eligible for analysis of treatment outcomes. Of the remaining 13 eyes, 4 had a visual acuity of 20/30 or better and therefore not subjected to any form of treatment. The natural course of these four patients was favorable and one of these patients has a follow up of 36 months with stable visual acuity and no intervention[Fig. 2]. In the two patients with bilateral disease, only one eye was treated as the fellow eye had advanced disease with very poor visual outcome. The remaining seven patients did not report for treatment. Pneumatic displacement was performed initially at the time of clinical presentation for submacular hemorrhage in six eyes.

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