Idiopathic polypoidal choroidal vasculopathy: a disease with diverse clinical spectrum and systemic associations

Purpose To report the clinical findings, angiographic results, clinical cou rse, response to laser photocoagulation and systemic associations in a grou p of patients with idiopathic polypoidal choroidal vasculopathy (IPCV). Methods All patients with IPCV attending the macular clinic underwent a com plete ocular examination, and fluorescein and indocyanine green angiography . In addition, a systemic examination including blood pressure, full blood count, plasma viscosity and coagulation status of patients was carried out. Results We present a series of 5 patients (7 eyes) with clinical and angiog raphic evidence of IPCV with follow-up of 3-6 years. We report diverse demo graphic and clinical manifestations. One patient had polypoidal lesions fou nd at the peripheral retina (anterior to equator) of both eyes. Three patie nts were treated with laser photocoagulation and achieved stable vision; 2 patients who had no laser treatment experienced deteriorated vision, one of whom had a vitrectomy. One patient was hypertensive, 2 patients were found to have raised plasma viscosity, and 1 patient had thrombocytopenia. Conclusions The clinical spectrum of IPCV is wider than previously document ed. It is a distinct clinical entity which should be differentiated from ot her forms of haemorrhagic and exudative maculopathy. The availability of in docyanine green angiography has allowed increased recognition of these case s. Early selective laser treatment on lesions affecting maculae could stabi lise the disease. Its association with systemic cardiovascular disease and blood disorder may predispose to the recurrence of haemorrhagic events in t his entity.