A case of polypoidal choroidal vasculopathy. Periphery is equally important for such patients
Dimitrios A Karagiannis, Vasilios Soublis, Artemios Kandarakis
1st Ophthalmology Department of Ophthalmiatrio Eye Hospital of Athens, Athens, Greece
Background: To report a case of peripheral polypoidal choroidal vasculopathy (PCV) which was treated successfully.
Methods: Interventional case report. Best-corrected visual acuity measurements (BCVA), slit-lamp examination, fundus biomicroscopy, fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were performed at baseline examination and during the follow-up period. The patient underwent ICGA-guided argon laser to treat the active polyps.
Results: An 82-year-old Caucasian man presented complaining of sudden deterioration of peripheral vision in his left eye (LE). His previous ocular history was associated with advanced age-related macular degeneration (AMD) involving both eyes (BE). Fundus examination revealed macular scars in BE and a large hemorrhagic pigment epithelial detachment (PED) temporal to the macula in the LE. ICGA revealed active polyps at the margins of the PED. The patient underwent ICGA-guided argon laser to treat the active polyps. Six months post-laser, the patient regained his peripheral vision with resolution of the hemorrhagic PED and remains stable until now, one year after treatment.
Conclusions: Appropriate treatment and regular follow-up is important in patients with PCV and peripheral lesions even if central vision is lost.
Keywords: argon laser, peripheral vision, polypoidal choroidal vasculopathy
Idiopathic polypoidal choroidal vasculopthy (PCV) represents about 8%–10% of cases of exudative maculopathy and is an exudative disorder of the macula. Although its pathogenesis remains unclear, it is generally thought to be an inner choroidal vascular abnormality. Choroidal vascular lesions of PCV are more preferable found in the posterior pole of the retina, although further evidence suggests that the lesion could also be found in the peripheral retina up to 63%. We report a case of peripheral PCV, treated successfully, in a male patient with advanced bilateral age-related macular degeneration affecting severely both foveal areas. The initial complain of the patient was deterioration of peripheral vision in addition to the already affected central vision. Such a clinical situation may impair significantly the quality of life of the patient and needs to be promptly identified, diagnosed, and treated in order to preserve, in the best possible way, the peripheral vision of the patient.
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