Thermal Laser Monotherapy for Extrafoveal Polypoidal Choroidal Vasculopathy

Abstract

Introduction Polypoidal choroidal vasculopathy (PCV) is a vascular disease of the choroid. Diagnosis is mainly based on polypoidal aneurysm-like lesions seen in indocyanine green (ICG) angiography. Various therapeutic options have been proposed.

Methods Outcomes of 10 cases with extrafoveal PCV and consecutive macular edema treated with thermal laser are reported. Diagnosis of PCV was confirmed by ICG angiography.

Results Upon successful occlusion of the polyps in 10 eyes after thermal laser treatment demonstrated in ICG angiography, a regression of central foveal edema was seen in optical coherence tomography and color fundus photography. Visual acuity improved from logMAR 0.8 to logMAR 0.3. Follow-up ranged from 4 months to 15 years, with a median of 1 year. Two eyes had a recurrence of exudative maculopathy 5 and 7 years after laser treatment, respectively.

Conclusion A careful differentiation between various subforms of exudative maculopathy using fluorescein and ICG angiography can identify certain selected patients with extrafoveal PCV, for whom thermal laser monotherapy can be a therapeutic option.

Zusammenfassung

Einleitung Die polypoidale chorioidale Vaskulopathie (PCV) ist eine Gefäßerkrankung der Chorioidea. Die Diagnose wird durch in der Indocyaningrünangiografie (ICG-Angiografie) sichtbaren polypoidalen aneurysmatischen Veränderungen gestellt. Es gibt verschiedene Therapiemöglichkeiten.

Methoden Die Ergebnisse von 10 Fällen mit extrafoveal gelegener PCV und daraus resultierendem Makulaödem nach Photokoagulation werden demonstriert. Die Diagnose der PCV war durch eine vorherige ICG-Angiografie gesichert worden.

Ergebnisse Nachdem der erfolgreiche Verschluss der Polypen in 10 Augen nach thermischer Laserkoagulation sich in der ICG-Angiografie darstellte, kam es ebenfalls zu einer Verminderung des Makulaödems zentral im OCT und in der Fundusfotografie. Die Sehschärfe stieg von 0,8 logMAR auf 0,3 logMAR.

Schlussfolgerung Eine sorgfältige Differenzierung der unterschiedlichen AMD-Unterformen und die Diagnose einer extrafovealen PCV durch die ICG-Angiografie kann geeignete Patienten identifizieren, die möglicherweise von einer einzigen Behandlung mit dem thermischen Laser profitieren und möglichen Strapazen durch andere Therapieoptionen entgehen können.

Key words

laser treatment - polypoidal choroidal vasculopathy - macula edema - indocyanine green angiography - retina - choroid

Schlüsselwörter

Chorioidea - Retina - Laser - polypoidale chorioidale Vaskulopathie - Makulaödem - Indocyaningrünangiografie

Publication History

Received: 21 July 2021

Accepted: 19 August 2021

Article published online:
29 September 2021

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