Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration

Objective: To determine the nature and frequency of polypoidal choroidal va sculopathy (PCV) in a series of patients suspected of having neovascularize d age-related macular degeneration (AMD). Methods: A prospective analysis of 167 consecutive, newly diagnosed patient s aged 55 years or older with presumed neovascularized AMD was performed. A ll patients were examined with fundus biomicroscopy as well as fluorescein and indocyanine green angiography. Results: Choroidal neovascularization secondary to AMD was diagnosed in 154 (92.2%) of 167 patients; 13 (7.8%) patients had PCV. The patients affected by PCV were younger than those with AMD (P=.01). Peripapillary choroidal n eovascularization was seen in 3 (1.9%) of 154 patients with AMD and 3 (23.1 %) of 13 patients with PCV (P=.006). Significant drusen were present in 63 (70%) of 90 fellow eyes with unilateral AMD compared with only 1 (16.7%) of 6 eyes with PCV (P=.02). Only 5 patients with AMD (3.2%) were nonwhite com pared with 3 patients with PCV (23.1%) (P=.02). Conclusions: A measurable number of elderly patients with findings suggesti ve of neovascularized AMD and serosanguineous macular manifestations will i nstead have PCV. Polypoidal choroidal, vasculopathy can occur in any sex or race, but is more commonly seen in the peripapillary area, without associa ted drusen, and in nonwhite patients. It is important to differentiate AMD from PCV because there are significant differences in the demographic risk profile, natural course, visual prognosis, and management of these patients .