Evaluation and management of polypoidal choroidal vasculopathy: Case reports and review

Purpose: To document a variety of cases of polypoidal choroidal vasculopathy (PCV) and their respective management. Review current concepts of PCV pathophysiology and therapy. Case Reports: Five cases of PCV are presented. All patients were examined with biomicroscopy, time domain optical coherence tomography (TDOCT) or spectral domain optical coherence tomography (SDOCT). Indocyanine Green (ICG) or fluorescein angiography (FA) was performed in two patients. Diagnosis confirmation was obtained from retinal specialists in four cases; three cases involving lesions distant from the macula or located peripherally did not receive treatment. One patient experienced a recurrence of the PCV lesion proximal to the optic nerve following treatment with photodynamic laser therapy (PDT). The final case discussed involves a patient with a PCV hemorrhagic serosaguineous detachment at the macula OD, which resolved following intra-vitreous injection of antivascular endothelial growth factor (VEGF); however, the patient did not significantly regain visual acuity. Conclusion: The presentation of PCV may vary according to individual genetic, environmental, and underlying systemic condition differences. Features of PCV include branching choroidal vessels with polypoidal aneurysmal end-vessel dilatations, retinal epithelium detachment (RPE) and serosanguineous detachments. The benefit of current treatment modalities may depend on individual factors. Documentation of treatment outcomes in PCV provides fundamentals for the improvement and tailoring of management in comparable cases.