Limits...
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.

Show MeSH

Related in: MedlinePlus

A 64-year-old female. (A) Note submacular hemorrhage. Visual acuity 20/120. (B and C) ICGA shows saccular dilatations in cluster. (D) 3 months following PDT note resolution. (E and F) ICGA shows regression of polyps. (G) Seven months later presents with recurrence. (H) ICGA demonstrates recurrence of polyps. (I) 3 months following PDT note the absorption of blood. (J) 17 months later presented with intraretinal lipid deposits in the macula and reduced vision. (K and L) ICG shows extrafoveal polyps. (M) Following thermal laser intraretinal lipids decreased. (N and O) ICGA shows regression of polyps (20/80)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2992915&req=5

Figure 0003: A 64-year-old female. (A) Note submacular hemorrhage. Visual acuity 20/120. (B and C) ICGA shows saccular dilatations in cluster. (D) 3 months following PDT note resolution. (E and F) ICGA shows regression of polyps. (G) Seven months later presents with recurrence. (H) ICGA demonstrates recurrence of polyps. (I) 3 months following PDT note the absorption of blood. (J) 17 months later presented with intraretinal lipid deposits in the macula and reduced vision. (K and L) ICG shows extrafoveal polyps. (M) Following thermal laser intraretinal lipids decreased. (N and O) ICGA shows regression of polyps (20/80)

Mentions: Eleven patients were treated with PDT. The demographic features and results of treatment are described in Table 1. Mean follow up was 15.9 months (3–39 months). Three eyes received intravitreal bevacizumab and one eye received intravitreal triamcinolone acetonide along with PDT. The purpose of combining intravitreal pharmacotherapy with PDT was to reduce the significant exudation. All the treated patients showed significant improvement in the form of resolution of exudates and hemorrhage at 3 months after regression of polyps in ICGA. Visual acuity improved in nine eyes, worsened in one eye and remained the same in one eye. A representative case is illustrated in Fig. 3.


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 64-year-old female. (A) Note submacular hemorrhage. Visual acuity 20/120. (B and C) ICGA shows saccular dilatations in cluster. (D) 3 months following PDT note resolution. (E and F) ICGA shows regression of polyps. (G) Seven months later presents with recurrence. (H) ICGA demonstrates recurrence of polyps. (I) 3 months following PDT note the absorption of blood. (J) 17 months later presented with intraretinal lipid deposits in the macula and reduced vision. (K and L) ICG shows extrafoveal polyps. (M) Following thermal laser intraretinal lipids decreased. (N and O) ICGA shows regression of polyps (20/80)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0003: A 64-year-old female. (A) Note submacular hemorrhage. Visual acuity 20/120. (B and C) ICGA shows saccular dilatations in cluster. (D) 3 months following PDT note resolution. (E and F) ICGA shows regression of polyps. (G) Seven months later presents with recurrence. (H) ICGA demonstrates recurrence of polyps. (I) 3 months following PDT note the absorption of blood. (J) 17 months later presented with intraretinal lipid deposits in the macula and reduced vision. (K and L) ICG shows extrafoveal polyps. (M) Following thermal laser intraretinal lipids decreased. (N and O) ICGA shows regression of polyps (20/80)
Mentions: Eleven patients were treated with PDT. The demographic features and results of treatment are described in Table 1. Mean follow up was 15.9 months (3–39 months). Three eyes received intravitreal bevacizumab and one eye received intravitreal triamcinolone acetonide along with PDT. The purpose of combining intravitreal pharmacotherapy with PDT was to reduce the significant exudation. All the treated patients showed significant improvement in the form of resolution of exudates and hemorrhage at 3 months after regression of polyps in ICGA. Visual acuity improved in nine eyes, worsened in one eye and remained the same in one eye. A representative case is illustrated in Fig. 3.

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