Prevalence of Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) in Thai Population Diagnosed with Choroidal Neovascularization (CNV)

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Yonrawee Piyacomn
Chavakij Bhoomibunchoo
Somanus Thoongsuwan
Nattapon Wongcumchang
Duangnate Rojanaporn
Adisai Varadisai
Pichai Jirarattanasopa
Eakkachai Arayangkoon
Atchara Amphornphruet
Nawat Watanachai
Sritatath Vongkulsiri

Abstract

Background and Objectives : Idiopathic polypoidal choroidal vasculopathy (IPCV) has become well-known among ophthalmologists in the past three decades. Its clinical manifestation once resembled those with neovascular age-related macular degeneration (AMD) of which presentations were like those with choroidal neovascularizations (CNVs). One of the effective treatments of IPCV is photodynamic therapy (PDT) with verteporfin which is supported by the Thai government for those with AMD but not with IPCV. Previous studies considered, we believe that IPCV are common than neovascular AMD. However, there is no such numerical data that could emphasize the impact this disease. Consequently, this multicenter study thus intended to study the prevalence of IPCV in Thailand.

Materials and Methods : The medical records, fundus photos, spectral domain optical coherence tomography (OCT),  fundus fluorescein angiograms (FFA) and indocyanine green angiograms (ICGA) on a series of 140 patients that were referred to ten referral centers all over Thailand were reviewed retrospectively.

 

Results :  Of 140 patients with the clinical signs of subretinal or sub-pigment epithelial blood, subretinal fluid, subretinal lipid, subretinal pigment ring, irregular elevation of pigment epithelium, subretinal gray-white lesion, cystoid macular edema and sea fan pattern of subretinal small vessels, 100 patients were diagnosed with IPCV (71.43 %) with a 95% confidence interval of 63.19%  to 78.74%

Conclusion : IPCV is not uncommon in Thailand. ICGA is valuable in diagnosis of this disease. The prognosis is not promising if left untreated. PDT with verteporfin is the effective treatment of choice.

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