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OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 178

Atypical case of polypoidal choroidal vasculoplathy


1 Vitreo-Retinal Surgeon and ROP Specialist, Sarakshi Netralaya, Nagpur, Maharashtra, India
2 Vitreo-Retinal Surgeon, Sarakshi Netralaya, Nagpur, Maharashtra, India
3 Ophthalmic Technician and Optometrist, Sarakshi Netralaya, Nagpur, Maharashtra, India

Date of Web Publication01-Apr-2021

Correspondence Address:
Dr. Shilpi H Narnaware
Vitreo-Retinal Surgeon and ROP Specialist, Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur - 440 025 Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2635_20

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How to cite this article:
Narnaware SH, Bawankule PK, Chivane A. Atypical case of polypoidal choroidal vasculoplathy. Indian J Ophthalmol Case Rep 2021;1:178

How to cite this URL:
Narnaware SH, Bawankule PK, Chivane A. Atypical case of polypoidal choroidal vasculoplathy. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Apr 10];1:178. Available from: https://www.ijoreports.in/text.asp?2021/1/2/178/312389



A 50-year-old female presented with blurring of vision in the RE of 6 days duration. Examination revealed 6/9 vision in the RE with unremarkable anterior segment findings. Fundus evaluation of right eye revealed tubular serous detachment over the macula [Figure 1]a. Optical coherence tomography (OCT) [Figure 1]b revealed double humped pigment epithelial detachment (PED). Fundus fluorescein angiography showed blocked fluorescence [Figure 1]c and [Figure 1]d and there was no detectable polyp on indocyanine green angiography (ICGA) [Figure 1]e and [Figure 1]f. The patient was advised a close follow up. Five days later, the patient presented with sudden diminution of vision in the RE with a vision of 2/60. Fundus examination revealed massive sub-hyaloid and sub-retinal bleed [Figure 1]g, with OCT showing large thumb shaped PED with fluid [Figure 1]h. The patient was advised and given anti-vascular endothelial growth factor injection intravitreally in the right eye.
Figure 1: Atypical PCV in a 50-year-old lady. Initial presentation of the patient with tubular serous retinal detachment at the macula (a), with a double-humped PED on OCT (b), early (c) and late (d) phase FFA showing blocked fluorescence and no detectable polyp on ICGA (e, f). Five days later, the patient showed subhyaloid and subretinal hemorrhage (g), with OCT showing large thumb-shaped PED with fluid (h)

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Findings in favour of polypoidal choroidal vasculopathy (PCV) include orange-red sub-retinal nodule, sub-retinal haemorrhage, serous/haemorrhagic PED[1],[2] with notched/thumb shaped PED, double layer sign,[3] pachychoroid vessels. Though ICGA is the investigation of choice in cases of PCV, in this case, no polyp was seen.

This case is atypical because of sudden progression of tubular detachment with no initial contributory findings from the investigations.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Koh AH, Expert PCV Panel, Chen LJ, Chen SJ, Chen Y, Giridhar A, et al. Polypoidal choroidal vasculopathy: Evidence based guidelines for clinical diagnosis & treatment. Retina 2013;33:686-716.  Back to cited text no. 1
    
2.
Honda S, Matsumiya W, Negi A. Polypoidal choroidal vasculopathy: Clinical features & genetic predisposition. Ophthalmologica 2014;231:59-74.  Back to cited text no. 2
    
3.
Sato T, Kishi S, Watanabe G, Matsumoto H, Mukai R. Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy. Retina 2007;27:589-94.  Back to cited text no. 3
    


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