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Pachychoroid neovasculopathy.
Retina. 2015 Jan; 35(1):1-9.R

Abstract

PURPOSE

To report 3 cases of pachychoroid neovasculopathy, a form of Type 1 (sub-retinal pigment epithelium) neovascularization, occurring over areas of increased choroidal thickness and dilated choroidal vessels.

METHODS

A retrospective observational case series of three patients who underwent comprehensive ophthalmic examination and multimodal imaging with fundus photography, fundus autofluorescence, spectral domain optical coherence tomography, enhanced depth imaging optical coherence tomography, fluorescein angiography, and indocyanine green angiography.

RESULTS

In all 3 eyes of 3 patients, aged 55 years to 63 years, there was Type 1 neovascularization overlying a localized area of choroidal thickening and dilated choroidal vessels seen with enhanced depth imaging optical coherence tomography. With indocyanine green angiography, there were large choroidal veins and choroidal hyperpermeability seen beneath the area of the neovascular tissue in all three eyes. No eyes had evidence of submacular exudative detachment or autofluorescence changes to suggest antecedent acute or chronic central serous chorioretinopathy. No eyes had drusen or degenerative changes to suggest age-related macular degeneration or other degenerative diseases. In one patient, the fellow unaffected eye demonstrated retinal pigment epithelium abnormalities, best seen with fundus autofluorescence, overlying focal dilated choroidal vessels seen with enhanced depth imaging optical coherence tomography and associated choroidal hyperpermeability seen with indocyanine green angiography, consistent with the diagnosis of pachychoroid pigment epitheliopathy. All three eyes showed the appearance of polypoidal structures within the neovascular tissue.

CONCLUSION

Pachychoroid neovasculopathy falls within a spectrum of diseases associated with choroidal thickening that includes pachychoroid pigment epitheliopathy, central serous chorioretinopathy, and polypoidal choroidal vasculopathy and should be considered as a possible diagnosis in eyes with features of Type 1 neovascularization and choroidal thickening in the absence of characteristic age-related macular degeneration or degenerative changes. Pachychoroid neovasculopathy may occur as a focal abnormality within the macula, even in myopic eyes with normal subfoveal choroidal thickness. Pachychoroid neovasculopathy can ultimately progress to the development of polypoidal choroidal vasculopathy.

Authors+Show Affiliations

*Vitreous, Retina, Macula Consultants of New York, New York, New York; †LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; and ‡Department of Ophthalmology, New York University School of Medicine, New York, New York.No affiliation info available

Pub Type(s)

Case Reports
Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25158945

Citation

Pang, Claudine E., and K Bailey Freund. "Pachychoroid Neovasculopathy." Retina (Philadelphia, Pa.), vol. 35, no. 1, 2015, pp. 1-9.
Pang CE, Freund KB. Pachychoroid neovasculopathy. Retina (Philadelphia, Pa). 2015;35(1):1-9.
Pang, C. E., & Freund, K. B. (2015). Pachychoroid neovasculopathy. Retina (Philadelphia, Pa.), 35(1), 1-9. https://doi.org/10.1097/IAE.0000000000000331
Pang CE, Freund KB. Pachychoroid Neovasculopathy. Retina (Philadelphia, Pa). 2015;35(1):1-9. PubMed PMID: 25158945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pachychoroid neovasculopathy. AU - Pang,Claudine E, AU - Freund,K Bailey, PY - 2014/8/28/entrez PY - 2014/8/28/pubmed PY - 2015/6/19/medline SP - 1 EP - 9 JF - Retina (Philadelphia, Pa.) JO - Retina (Philadelphia, Pa.) VL - 35 IS - 1 N2 - PURPOSE: To report 3 cases of pachychoroid neovasculopathy, a form of Type 1 (sub-retinal pigment epithelium) neovascularization, occurring over areas of increased choroidal thickness and dilated choroidal vessels. METHODS: A retrospective observational case series of three patients who underwent comprehensive ophthalmic examination and multimodal imaging with fundus photography, fundus autofluorescence, spectral domain optical coherence tomography, enhanced depth imaging optical coherence tomography, fluorescein angiography, and indocyanine green angiography. RESULTS: In all 3 eyes of 3 patients, aged 55 years to 63 years, there was Type 1 neovascularization overlying a localized area of choroidal thickening and dilated choroidal vessels seen with enhanced depth imaging optical coherence tomography. With indocyanine green angiography, there were large choroidal veins and choroidal hyperpermeability seen beneath the area of the neovascular tissue in all three eyes. No eyes had evidence of submacular exudative detachment or autofluorescence changes to suggest antecedent acute or chronic central serous chorioretinopathy. No eyes had drusen or degenerative changes to suggest age-related macular degeneration or other degenerative diseases. In one patient, the fellow unaffected eye demonstrated retinal pigment epithelium abnormalities, best seen with fundus autofluorescence, overlying focal dilated choroidal vessels seen with enhanced depth imaging optical coherence tomography and associated choroidal hyperpermeability seen with indocyanine green angiography, consistent with the diagnosis of pachychoroid pigment epitheliopathy. All three eyes showed the appearance of polypoidal structures within the neovascular tissue. CONCLUSION: Pachychoroid neovasculopathy falls within a spectrum of diseases associated with choroidal thickening that includes pachychoroid pigment epitheliopathy, central serous chorioretinopathy, and polypoidal choroidal vasculopathy and should be considered as a possible diagnosis in eyes with features of Type 1 neovascularization and choroidal thickening in the absence of characteristic age-related macular degeneration or degenerative changes. Pachychoroid neovasculopathy may occur as a focal abnormality within the macula, even in myopic eyes with normal subfoveal choroidal thickness. Pachychoroid neovasculopathy can ultimately progress to the development of polypoidal choroidal vasculopathy. SN - 1539-2864 UR - https://www.unboundmedicine.com/medline/citation/25158945/Pachychoroid_neovasculopathy_ L2 - http://dx.doi.org/10.1097/IAE.0000000000000331 DB - PRIME DP - Unbound Medicine ER -