Authors: Isaac Alarcon, Daniel Vilaplana, Vladimir Poposki, Olga Martinez-Giralt, Miguel Castilla, Xenia Acebes, Barcelona, Spain

Advantages / Purpose:

Polypoidal choroidal vasculopathy is a disease with characteristic choroidal vascular abnormalities. Although the polypoidal choroidal vasculopathy and age-related macular degeneration have been known to share common genetic factors, its clinical characteristics suggest that polypoidal choroidal vasculopathy is a separate clinical entity from age-related macular degeneration. Indocyanine green angiography is essential for diagnosis. The prevalence is higher in Asian people than in Caucasians. In some cases a spontaneous resolution can occur with no treatment at all. The results of photodynamic therapy for polypoidal choroidal vasculopathy are encouraging.

A lower efficacy of bevacizumab has been shown for polypoidal choroidal vasculopathy. Recurrence may affect vision over time. Methods: Two females, 50 and 75 years old with subacute visual loss. ICG angiography demonstrates the presence of polypoidal choroidal vasculopathy. In one case the polypoidal lesion disappears without treatment. The other case is treated with focal PDT showing a complete resolution of the lesion.

Effectiveness / Safety:

The visual acuity in both cases is recovered partially and it is stable 12 months later with no recurrence of the lesion.

Take home message:

As Polypoidal choroidal vasculopathy has a difficult management, when the polypoidal lesion is out from the fovea, it is fair to wait and see its behavior. In case the treatment is needed, the PDT is the best option. However, a treatment that stops the recurrences is not available yet.