PVC and Occult AMD in a Series of AMD Cases

Purpose:To evaluate by means of dynamic indocyanine green angiography (ICGA) the association between polypoidal choroidal vasculopathy (PVC) and neovascular AMD. Methods:A series of 40 eyes of 33 consecutive patients with PVC (19 females and 14 males, mean age 71.5 years) were retrospectively analyzed. All patients had received an ophthalmic examination, and dynamic fluorescein angiography (FA and ICGA) with Heidelberg Retina Angiograph (HRA). Results:PVC was present at the first angiography in 62.5% of cases and developed in 37.5% during follow up. In the first group isolated PVC was present in 48% and it was associated with exudative AMD in 52% (occult in 77%, minimally classic in 23%). This group of patients was followed up for 3 years. In 8% PVC regressed spontaneously, in 44% after treatment (45% PDT, 18% Avastin 36.3 % combined therapy).PVC persisted in 24% of treated cases in 24% with no treatment.In the second group, PVC developed in eyes with exudative AMD ( 80% occult AMD) after a mean period of 4.2 years. Noteworthy 73% of these cases had been treated previously with anti-VEGF or PDT. In this group, PVC recovered spontaneously in 13.3%, and in 33.3% after retreatment (20% PDT, 20% Avastin 60% focal argon laser). 53.3% did not recover. Conclusions:Our data suggest a strong association between PVC and occult AMD which could be the expression of the same disease process. PVC occurred frequently in AMD following treatment.