Association of Chorioretinal Anastomosis and Polypoidal Choroidal Vasculopathy - Relation or Coincidence? Report of 4 Cases

Abstract

Abstract: : Purpose: To analyse of different clinical patterns considered as part of Aged Related Macular Degeneration (AMD). Methods: Retrospective study of four non-treated eyes of four patients presenting with wet AMD. A high-speed infracyanin-green (HS-ICG) video-angiography, performed to analyse the choroido-retinal anastomoses(RCA) showed the simultaneous presence of choroidal polypoidal vasculopathy. Results:The choroidal dilatations were within the zone of a vascularized pigment epithelium detachment, within an area of 1.236 to 3.032 mm from the anastomosis. In two cases, other polypoidal malformations were observed close to the optic nerve head. Their pattern on ICG-angiography was caracteristic. In all cases, one RCA was observed with the participation of one arterial and at least two venous retinal vessels. A subfoveal occult membrane was present in all cases with the association of hard exudates, of cystoid macular edema and, in 2 eyes, with intra retinal hemorrages localised on RCA. Conclusions: The simultanous presence of these two clinical entities was never described in the literature, although a possible common pathogenesis may be suggested. The HS-ICG analysis could allow the study of the sequence of development of these two vascular abnormalities.

Keywords: age-related macular degeneration • choroid: neovascularization • imaging methods (CT, FA, ICG, MRI, OCT, RTA, S