scholarly journals Valsalva-Related Subretinal Hemorrhage as a Presenting Symptom of Polypoidal Choroidal Vasculopathy

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Yousif Subhi ◽  
Torben L. Sørensen
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Rare Case ◽  
Indocyanine Green Angiography ◽  
Pigment Epithelium ◽  
Subretinal Hemorrhage ◽  
Pigment Epithelium Detachment ◽  
Subretinal Fibrosis ◽  
The Right ◽  
Choroidal Vasculopathy ◽  
Intraretinal Cysts

Purpose. To describe a case of Valsalva-related subretinal hemorrhage as a presenting symptom of polypoidal choroidal vasculopathy (PCV). The patient refrained from treatment against our best advice, and thus this is also a rare case of the natural course of an untreated PCV. Methods. Case report. Results. A 66-year-old female with a respiratory infection coughed intensely until exhaustion, after which she developed visual symptoms on the right eye. Primary care ophthalmologist examined the patient on the same day of the onset of symptoms and referred her to our tertiary medical retinal service for detailed retinal diagnosis including fluorescein and indocyanine green angiography. The right eye had a large subretinal hemorrhage and pigment epithelium detachment in the lower temporal arcade with foveal involvement. Against our best advice, the patient refused treatment. In the following 9 months, the BCVA decreased from 68 to 55 ETDRS letters, the subretinal hemorrhage almost regressed, pigment epithelium detachments persisted, and macular edema, intraretinal cysts, and subretinal fibrosis developed. Conclusions. Although classic Valsalva retinopathy with preretinal hemorrhage in most cases can be managed by careful observation and no treatment, this case demonstrates that Valsalva-related subretinal hemorrhage needs different attention and approach.

scholarly journals Polypoidal Choroidal Vasculopathy – A Type I Polypoidal Subretinal Neovasculopathy

2013 ◽  
Vol 7 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Gregg T Kokame
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
High Dose ◽  
Type I ◽  
Vascular Abnormality ◽  
Icg Angiography ◽  
New Development ◽  
The Right ◽  
Choroidal Vasculopathy

This 47 year old female developed the new onset of a polypoidal subretinal neovascular membrane in the left eye 13 years after having polypoidal choroidal vasculopathy (PCV) treated in the right eye. The indocyanine green (ICG) angiography of the left eye at initial presentation showed a normal choroidal vascular pattern without PCV. The new development of a PCV complex on ICG angiography demonstrates that PCV is truly a type of subretinal neovascularization, and not a choroidal vascular abnormality. The optical coherence tomography shows that the polypoidal vascular complex lies above Bruch’s membrane and beneath the retinal pigment epithelium, and not within the choroid. Treatment with high dose ranibizumab (2.0 mg) resulted in excellent polyp closure and regression of the branching vascular network. The documented new development of polypoidal subretinal vessels on ICG angiography and the response to ranibizumab supports that PCV is a polypoidal neovasculopathy (PNV).

scholarly journals Non-Invasive Diagnosis of Polypoidal Choroidal Vasculopathy as a Variant of the Course of Age-Related Macular Degeneration

2018 ◽  
Vol 15 (2S) ◽  
pp. 273-280 ◽  
Author(s):  
I. E. Panova ◽  
T. B. Shaimov ◽  
V. A. Shaimova
Keyword(s):  
Indocyanine Green ◽  
Macular Degeneration ◽  
Polypoidal Choroidal Vasculopathy ◽  
Indocyanine Green Angiography ◽  
Pigment Epithelium ◽  
Clinical Signs ◽  
Age Related Macular Degeneration ◽  
Oct Angiography ◽  
Age Related ◽  
Choroidal Vasculopathy

Purpose: to study noninvasive diagnostic options for polypoidal choroidal vasculopathy (PCV) — a subtype of neovascular agerelated macular degeneration — by monitoring clinical progression, defining optical coherence tomography (OCT) findings specific for PCV and evaluating diagnostic utility of OCT angiography.Patients and methods. The study included 254 patients (292 eyes) with neovascular age-related macular degeneration. All patients underwent complex eye examination: visual acuity test, slit lamp biomicroscopy, ophthalmoscopy with 60 and 78D fundus lenses, fundoscopy with color filters, spectral-domain OCT, OCT angiography and biometry. Fluorescein angiography was performed in 66 cases. Indocyanine green angiography was employed in 16 patients with PCV. All statistical analyses were performed with IBM SPSS Statistics 19 software package.Results. In 14 of 16 patients (87.5%) indocyanine green angiography revealed round hyperfluorescent lesions which corresponded to ophthalmoscopy findings — subretinal reddish orange nodules localized primarily in the parafovea. In 11 cases (68.8%) the nodules were associated with hemorrhage and in 14 cases (87.5%) — with hard yellowish exudates. Comparative analysis of retinal anatomy allowed for defining typical OCT signs of PCV that distinguish the clinical entity from type 1 and 2 choroidal neovascular membranes: neurosensory retinal detachment in the parafovea (80.0%, p < 0.001) and hard exudates (71.9%, p < 0.001). OCT findings characteristic of PCV are dome-shaped pigment epithelium detachment (100%), bubble sign (94.74%), notch sign (68.4%) and double layer sign (92.9%).Conclusion. Noninvasive diagnosis of polypoidal choroidal vasculopathy should encompass clinical signs, fundoscopy findings, OCT-based morphometry and OCT angiography criteria. OCT angiography has high diagnostic value and enables detection of branching vascular network and polypoidal formations. 

scholarly journals Visual Parameters and Retinal Morphology for Polypoidal Choroidal Vasculopathy Pre- and Post-Intravitreal Ranibizumab with or without Photodynamic Therapy: A Short-Term Prospective Study

2021 ◽  
Vol 18 (5) ◽  
pp. 2581
Author(s):  
Rituparna Ghoshal ◽  
Sharanjeet Sharanjeet-Kaur ◽  
Norliza Mohamad Fadzil ◽  
Somnath Ghosh ◽  
Nor Fariza Ngah ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Prospective Study ◽  
Polypoidal Choroidal Vasculopathy ◽  
Reading Speed ◽  
Pigment Epithelium ◽  
Post Treatment ◽  
Base Line ◽  
Intravitreal Ranibizumab ◽  
Pre Treatment ◽  
Choroidal Vasculopathy

The objective of this study was to compare visual parameters and retinal layers’ morphology pre-treatment (baseline) and 6 months post-treatment in polypoidal choroidal vasculopathy (PCV) eyes. A single centre, longitudinal, prospective study was conducted at a public tertiary hospital of Malaysia. Visual parameters including distance and near visual acuity (DVA and NVA), contrast sensitivity (CS), reading speed (RS), and different qualitative and quantitative optical coherence tomography (OCT) parameters were evaluated pre- and 6 months post-treatment. Thirty-three naïve PCV eyes of 32 patients (mean age of 67.62 years) were evaluated pre- and post-treatment of intravitreal ranibizumab with and without photodynamic therapy. After treatment, sub retinal fluid decreased from 27 eyes (84.35%) at baseline to 7 eyes (21.88%) at 6 months while pigment epithelium detachment decreased from 32 eyes (100%) at base line to 15 eyes (46.87%) at 6 months. Mean pre-treatment quantitative morphological OCT retinal parameters including thickness and volume of central sub field, center thickness, center minimum, and maximum thickness reduced significantly. Similarly, all visual parameters including DVA, NVA, CS, and RS showed statistically significant improvement. While 89% of the eyes showed improvement in CS, 78%, 71%, and 65% of the eyes showed improvement in NVA, RS, and DVA, respectively. Thus, CS was the most treatment responsive visual parameter.

scholarly journals Polypoidal Choroidal Vasculopathy in Congolese Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Nelly N. Kabedi ◽  
David L. Kayembe ◽  
Gloria M. Elongo ◽  
Jean-Claude Mwanza
Keyword(s):  
Optical Coherence Tomography ◽  
Indocyanine Green ◽  
Polypoidal Choroidal Vasculopathy ◽  
Indocyanine Green Angiography ◽  
Clinical Presentation ◽  
Case Series ◽  
Systemic Hypertension ◽  
Optical Coherence ◽  
Blurred Vision ◽  
Choroidal Vasculopathy

Purpose. Polypoidal choroidal vasculopathy (PCV) is a visually debilitating disease that mostly affects people of African and Asian heritage. Indocyanine green angiography (ICGA) is the recommended exploratory method for definitive diagnosis. The disease has been extensively described in Asians and Caucasians, but not in Africans. This study was conducted to document the clinical presentation and optical coherence tomography features of polypoidal choroidal vasculopathy (PCV) in Congolese patients. Methods. A prospective case series of patients with PCV was performed between January 2017 and June 2019. Routine ocular examination was performed including best corrected visual acuity measurement, slit-lamp examination, dilated direct fundoscopy, and spectral domain optical coherence tomography (OCT). The diagnosis was based on a combination of clinical and OCT signs. Results. Fourteen patients were diagnosed with PCV during this period. The average age was 64.7 ± 6.9 years. There were 8 females. Ten (71.4%) patients had systemic hypertension. Most patients (n = 9, 64.3%) had bilateral involvement. Blurred vision was the most common complaint (71.4%). The main clinical presentation was subretinal exudates, seen in 19 (82.6%) eyes of 11 (78.6%) patients and subretinal hemorrhage in 10 (43.5%) eyes. Macular localization was found in 16 eyes (69.5%) of 12 (85.7%) patients. Drusen were observed in 35.7% of the patients. On OCT imaging, thumb-like pigment epithelial detachment and subretinal exudation were the most frequent features, observed in 92.9% and 71.4% of the patients, respectively. Conclusions. PCV in Congolese patients showed features that are more similar to those observed in Caucasians. In this setting where indocyanine green angiography is not available, OCT facilitates the diagnosis of PCV.

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