Polypoidal choroidal vaculopathy: natural hitory

PURPOE: The preent tudy wa performed to clarify the long-term natural hitory of polypoidal choroidal vaculopathy (PCV). DEIGN: Propective, conecutive obervational cae erie. METHOD: Fourteen eye of 12 conecutive patient with PCV were propectively followed in our clinic for at leat 2 year without any treatment after a firt viit to the clinic between February 1996 and November 1998. All patient underwent complete ophthalmologic examination, color fundu photography, and fluorecein and indocyanine green (ICG) angiography at regular interval. Incluion criteria were a follow: eye had erou and/or hemorrhagic pigment epithelium detachment (PED) and retinal detachment in the poterior pole, and ICG angiography revealed a branching vacular network with polypoidal dilation at the terminal of the network. Excluion criteria were a follow: other dieae uch a exudative age-related macular degeneration, high myopia, angioid treak, and preumed ocular hitoplamoi yndrome, and patient who previouly underwent any ocular urgery. REULT: Patient were followed for mean of 39.9 month (range, 24–54 month). PCV wa preent in 10 (83%) men and two women and in the elderly (mean age 68.1 year), uually unilateral (83%) with vacular leion located at the macula (93%). The PCV manifeted in two pattern, exudative and hemorrhagic. In the exudative pattern, erou PED and retinal detachment were predominant at the macula. The hemorrhagic pattern wa characterized by hemorrhagic PED and ubretinal hemorrhage at the macula. ICG angiography revealed polypoidal choroidal neovacularization that wa changeable in appearance and repeatedly grew and pontaneouly regreed, but the vacular network perited. In ome eye, a collection of mall aneurymal dilation of veel reembling a cluter of grape appeared and all of them had marked bleeding and leakage and wore outcome. CONCLUION: Polypoidal choroidal vaculopathy i a long peritent chronic dieae and the patient had a variable coure. Fifty percent of the patient had a favorable coure. In the remaining half of the patient, the diorder perited for a long time with occaional repeated bleeding and leakage, reulting in macular degeneration and viual lo. Eye with a cluter of grape-like polypoidal dilatation of the veel had a high rik for evere viual lo.