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Clinical Features of Polypoidal Choroidal Vasculopathy and Visual Outcomes in the Absence of Classic Choroidal Neovascularization

Background/Aims: To report on the clinical features of polypoidal choroidal vasculopathy (PCV) and to delineate visual outcomes in the absence of classic choroidal neovascularization (CNV). Methods: Records were retrospectively reviewed of 233 eyes of 215 patients diagnosed with ‘definite’ PCV using Japanese criteria. Results: Of patients with definite PCV, 72.1% were men and 91.6% had unilateral disease. A history of systemic hypertension was elicited in 18.1% of patients, and blood pressure measurement revealed possible hypertension in 27.4% of patients. At the initial evaluation, 28.3% of eyes had classic CNV as assessed by fluorescein angiography and were treated by photodynamic therapy or other means. Of 112 eyes with active exudation but no classic CNV and no recent decreased vision, best-corrected visual acuity (BCVA) at 3 months improved by ≧0.2 logarithm of the minimum angle of resolution (logMAR) in 17%, was unchanged in 72% and worsened by ≧0.2 logMAR in 11%. In 67 eyes of which 1-year data were available, BCVA improved in 19%, was unchanged in 64% and worsened in 16%. Conclusions: The majority of PCV patients were men, with a high rate of diagnosed or suspected hypertension. More than two thirds of eyes had no evidence of classic CNV, of which 89% had stable or improved vision at 3 months without specific treatment. Of eyes followed for 12 months, 83% had stable or improved vision.