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Polypoidal Choroidal Vasculopathy

Chronic exudative-hemorrhagic maculopathy characterized by abnormal branching choroidal vascular network with terminal aneurysmal polypoidal dilatations causing recurrent serous and hemorrhagic pigment epithelial detachments, especially in patients of Asian and African descent.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Polypoidal Choroidal Vasculopathy?

Polypoidal choroidal vasculopathy (PCV) is a chorioretinal vascular disorder characterized by an abnormal branching vascular network in the inner choroid with terminal polypoidal aneurysmal dilatations. It causes recurrent serous and hemorrhagic pigment epithelial detachments (PED), subretinal exudation and hemorrhage, and progressive vision loss.

PCV is more prevalent in Asian (especially Japanese, Chinese, Korean), African, and Hispanic populations than Caucasians, where it accounts for 23-55% of presumed neovascular AMD. Pathogenesis is debated: considered by some a distinct entity arising from the inner choroid, by others a subtype of type 1 macular neovascularization (MNV) in AMD spectrum.

Diagnosis requires indocyanine green angiography (ICGA) showing characteristic polyps and branching vascular network in early/mid frames. OCT shows notched or sharp peaked PED, double layer sign (BVN beneath RPE), and subretinal fluid/hemorrhage. Treatment includes intravitreal anti-VEGF (aflibercept, faricimab) as first line, photodynamic therapy (PDT) for incomplete polyp regression, and combination therapy for refractory cases.

Symptoms

Gradual or sudden central vision loss
Metamorphopsia (distorted vision)
Central scotoma
Sudden severe vision loss with subretinal hemorrhage
Recurrent fluctuating vision
Often unilateral but can be bilateral

Risk Factors

Asian, African, or Hispanic ethnicity
Age >50 years
Smoking, hypertension
Genetic factors (CFH, ARMS2, HTRA1 polymorphisms)
Male sex (vs typical AMD female predominance)
Pachychoroid disease spectrum

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden or gradual central vision loss
  • Distorted vision (metamorphopsia)
  • Sudden severe vision loss
  • Known AMD with new symptoms
  • Family history of macular disease
  • Vision changes in Asian, African, or Hispanic individual >50

Treatment Methods

01
Comprehensive ophthalmology evaluation with dilated fundus examination
02
OCT (notched/sharp peaked PED, double layer sign, subretinal fluid)
03
Indocyanine green angiography (ICGA) — gold standard for polyp visualization
04
Fluorescein angiography (occult or minimally classic CNV pattern)
05
Intravitreal anti-VEGF: aflibercept, faricimab, ranibizumab (loading then treat-and-extend)
06
Photodynamic therapy (PDT) with verteporfin for incomplete polyp regression or massive PED
07
Combination therapy (anti-VEGF + PDT) for refractory cases; long-term monitoring required

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.