Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.
Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal.
Ophthalmologica. 2021;244(4):315-325. doi: 10.1159/000515295. Epub 2021 Feb 17.
The aim of the study was to characterize the morphological features of polypoidal choroidal vasculopathy (PCV) in a large Caucasian population.
We conducteda multicenter, cross-sectional study of treatment-naïve patients with PCV. Baseline fundus photography, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA) were assessed by trained medical graders. Typical PCV features were explored, and retinal thickness (RT) and choroidal thickness (CT) measurements were performed.
Seventy-nine eyes of 73 patients (mean age, 72.6 ± 11.9 years) were included. ICGA identified macular polyps in 89.9% of cases. SD-OCT revealed mostly subretinal fluid (93.6%) and a retinal pigment epithelium (RPE) detachment in 91.4%, with sharp protrusion in 67.0% of cases. Polyp-like structures were seen in 74.3% of cases, mostly adherent to an elevated RPE (69.6%). Type 1 neovascularization (NV) was identified in 74.7% of patients, while 16.5% had a mixed NV. The mean macular CT was 220.9 ± 83.2 μm (range, 67.9-403.6). Diffuse and focal pachychoroid were observed in 26.6 and 30.4% of patients, respectively. Soft drusen were reported in 62.0% of cases, but retinal hemorrhage occurred in only 19.0% of cases.
The morphological features of PCV in Caucasians are similar to those reported in Asians. Pachychoroid signs were found in nearly half of our cohort. However, the mean age at presentation, high prevalence of soft drusen, and low prevalence of large subretinal hemorrhages make PCV closer to age-related macular degeneration in this ethnic group.
本研究旨在描述大型白种人群中息肉样脉络膜血管病变（PCV）的形态特征。
我们开展了一项多中心、横断面研究，纳入了未经治疗的 PCV 患者。通过受过培训的医学分级员评估基线眼底照相、谱域光相干断层扫描（SD-OCT）、荧光素血管造影（FA）和吲哚青绿血管造影（ICGA）。探讨了典型的 PCV 特征，并进行视网膜厚度（RT）和脉络膜厚度（CT）测量。
纳入 73 例患者的 79 只眼（平均年龄 72.6±11.9 岁）。ICGA 在 89.9%的病例中发现了黄斑息肉。SD-OCT 显示 93.6%的病例主要为视网膜下液，91.4%的病例伴有视网膜色素上皮（RPE）脱离，67.0%的病例伴有锐利突起。74.3%的病例可见息肉样结构，大多附着于抬高的 RPE（69.6%）。74.7%的患者存在 1 型新生血管（NV），16.5%的患者存在混合 NV。黄斑 CT 平均为 220.9±83.2μm（范围，67.9-403.6μm）。26.6%的患者存在弥漫性和局限性肥厚脉络膜，分别为 30.4%。62.0%的病例报告有软性玻璃膜疣，但仅 19.0%的病例发生视网膜出血。
白种人群中 PCV 的形态特征与亚洲人群报道的相似。在我们的队列中，近一半的患者存在肥厚脉络膜征象。然而，该人群的发病年龄较高、软性玻璃膜疣的发生率较高、大的视网膜下出血发生率较低，使 PCV 更接近年龄相关性黄斑变性。
