Polypoidal Choroidal Vasculopathy

Polypoidal Choroidal Vasculopathy (PCV) is thought to be a variant of AMD that occurs in the slightly younger middle-aged adults. It is characterised by retinal bleeding from ‘polypoidal-like’ abnormal choroidal vessels.

What is Polypoidal Choroidal Vasculopathy (PCV)?

Polypoidal Choroidal Vasculopathy (PCV) is a condition that affects the vascular layer in the eye called the ‘Choroid’. This layer houses the blood vessels in the eye, and lies directly underneath the retina. When the structure of blood vessels in the choroid (choroidal vasculature) are studied closely under magnification, the condition is said to resemble a network of polyp-like growths. These abnormal growths result in damage to the cells responsible for receiving light that enters the eye, found in the retina right above the choroid. When these cells are damaged, the visual acuity of the patient is affected or compromised.

What symptoms does Polypoidal Choroidal Vasculopathy (PCV) present?

Patients with PCV will often experience blind spots or blurred vision, mostly at close to, or at the centre of their vision. This symptom can appear in a single eye, or both. Symptoms can appear suddenly and without any milder telltale signs.

Eye specialists often spot the signs of Polypoidal Choroidal Vasculopathy (PCV) before the patients themselves notice the symptoms.

What causes Polypoidal Choroidal Vasculopathy (PCV)?

The exact cause of Polypoidal Choroidal Vasculopathy are currently unknown. However, data collected shows trends of groups of people that are more prone to developing this condition.

Polypoidal Choroidal Vasculopathy occurs more frequently in persons over the age of 60, although, it there have been cases of much younger patients. Genetically, those hailing from asian or african descent are more likely to develop this condition.

Polypoidal Choroidal Vasculopathy (PCV) shares a good number of clinical features with another eye condition known as Wet Age-related Macular Degeneration. The blood vessels affected by PCV cause loss of visual acuity, or even loss of vision when they leak blood or fluid into the eye. Scarring of the retina and atrophy of photodynamic cells in the affected areas may also be caused by the abnormal blood vessels affected by PCV.

Patients often start showing symptoms of Polypoidal Choroidal Vasculopathy in one eye initially, but often develop the condition in their other eye with time. As such, eye specialists take extra care monitor and spot signs of Polypoidal Choroidal Vasculopathy developing in the patients’ healthy eyes. Early detection and management of this condition is crucial in ensuring that loss of visual acuity to this disease is kept to the absolute minimum.

What tests are there to detect Polypoidal Choroidal Vasculopathy?

The earliest test for detecting Polypoidal Choroidal Vasculopathy is the most important – and this would be to have your eye specialist perform an eye examination with your eye dilated. If necessary, your eye specialist might then recommend a fluorescein angiography or an indocyanine green angiography. These test have the ability to present detailed images of the blood vessels in the affected area. Studying these images will allow your eye specialist to better identify abnormalities in your eye and make a more accurate diagnosis.

Both the fluorescein angiography and the indocyanine green angiography will require a special kind of dye to be injected into a vein, typically in the arm or hand. After the dye is administered, the patient is then brought to have the retinas photographed. The dye will allow the abnormalities to show better during the imaging process and allows for better diagnosis by the specialist.

What is the treatment for Polypoidal Choroidal Vasculopathy like?

Treatments for Polypoidal Choroidal Vasculopathy have some similarity to another condition: Wet Age-Related Macular Degeneration (Wet AMD). In both conditions, a substance known as Vascular Endothelial Growth Factor (VEGF) causes leakage of blood and fluid from the abnormal blood vessels that occur both in Wet Form Age-Related Macular Degeneration and PCV. In order to stem the hemorrhage from the affected blood vessels, intraviteal injections of anti-VEGF drugs are required, depending on the patient and severity, these injections can happen as often as once every 4-6 weeks. The intended result is to control the leakage of blood and/or fluid leaked.

Photodynamic Therapy (PDT) is also used in the treatment of Polypoidal Choroidal Vasculopathy. In Photodynamic Therapy (PDT) of treatment for Polypoidal Choroidal Vasculopathy, a special type of drug is administered to the patient with PCV via injection. This drug makes the eye more sensitive to light. A specific cold laser is then used to destroy the abnormal blood vessels in the eye.

A third treatment option is used only if there are no better options available — a surgical virectomy. This surgery procedure removes the vitreous gel in the eye, and during this process, may also be used to surgically remove the fluids and blood leaked into the eye due to Polypoidal Choroidal Vasculopathy.

Despite the fact that treatment methods share similarity to that of Wet Age-Related Macular Degeneration, we recognise all patients with PCV are different and must be studied carefully for the best outcome to preserve visual acuity and optical coherence. Contact us to find out more on the individualised treatment plan that we are able to offer here at Asia Retina.

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