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Chen Zhongshan, Yanping Song; Clinical characteristics of polypoidal choroidal vasculopathy in central Chinese patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):671.
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To investigate the frequency and clinical characteristics of polypoidal choroidal vasculopathy (PCV) in elderly Central Chinese patients.
This study included 1321 consecutive patients with age-related choroidal neovascularization who aged 50 years or older. PCV or neovascularization age-related macular degeneration (nAMD) was diagnosed by ocular fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The incidence of PCV in these patients with nAMD was calculated and the clinical characteristics of PCV were analyzed.
Of the 1321 consecutive patients, 569 patients (43.1%) were ultimately diagnosed as PCV. The mean age was 64.8 years. 391 patients (68.7%) were male and 502 patients (88.2%) were unilaterally involved. Of the 636 affected eyes, 66.4% were found with large subretinal hemorrhage, 45.9% with yellowish-white exudates, 40.3% with typical reddish-orange lesions, 5.7% with drusen, and 5.2% with pigment proliferation. The PCV lesions were found in the macular region in 82.9% of eyes, 13.2% in the peripapillary area, and 3.9% in other areas. 75.3% of eyes presented with typical polypoidal lesions, and 37.9% with abnormal branching choroidal networks. Hemorrhagic retinal pigment epithelial detachment (PED) was found in 49.5%, serous PED in 23.9%, and both appeared in 6.1% of eyes. OCT revealed 26.9% of eyes with double-deck signs due to the separation of retinal pigment epithelium and Bruch's membrane, and 13.9% with cystoid dark chambers in the neurosensory retina. 67.9% of eyes showed vault-like elevation beneath the RPE layer and 37.6% with neurosensory retinal detachment.
PCV is very common in elderly Central Chinese patients with choroidal neovascularization. In this study, the majority of PCV patients were male and unilaterally affected. PCV lesions were mostly located in the macular region. Subretinal hemorrhage, polypoidal lesions, abnormal choroidal vascular networks and featured OCT images were usual in PCV patients, but less drusen comparing with AMD.
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