A CASE OF EVISCERATION DUE TO POLYPOIDAL CHOROIDAL VASCULOPATHY

Title A CASE OF EVISCERATION DUE TO POLYPOIDAL CHOROIDAL VASCULOPATHY
Author, Co-Author Kristen Hallowell, Taline Farra
Topic
Year
2004
Day
Program Number
Poster 102
Room
Affiliation
New England College of Optometry
Abstract BACKGROUND: Polypoidal Choroidal Vasculopathy (PCV) is characterized by an idiopathic network of branching vessels in the inner choroid with terminal aneurysmal dilatations. It is a distinct clinical entity associated with multiple, recurrent serosanguineous detachments of the neurosensory retina and RPE caused by leakage and bleeding from the abnormal choroidal lesions. Its complications are often misdiagnosed as CNVM due to ARMD.

CASE REPORT(S): A 54 yo black female was referred to the eye clinic from urgent care. She complained of reduced vision OD for 2 weeks. She admitted to uncontrolled HTN x 10 years and Type II DM x 4 years. Her best corrected VAs were 20/30 OD and 20/20 OS. EOM, confrontation field and pupillary testing were normal. Her IOP was 13 OU and anterior segment evaluation was unremarkable OU. Posterior segment evaluation revealed a vitreal hemorrhage OD and as a result the retina was not well visualized. In the left eye, there were multiple saccule-like lesions beneath the retina surrounding the optic nerve. The patient was referred to ophthalmology for retinal imaging where she underwent fluorescein and indocyanine green (ICG) angiographies. ICG angiography showed the saccules fill like a cluster of grapes underneath the retina. Although the patient was being followed closely by ophthalmology, she subsequently developed a complete retinal detachment with hemorrhagic glaucoma in her right eye, which had to be eviscerated. On follow up, the patient did not have any visual complaints of her left eye. Her entering VA was 20/20 but dilated fundus exam revealed an area of subretinal hemorrhage with exudation along the superior arcade. She was again referred to the retina clinic where they performed laser photocoagulation of the leaky vessels.

CONCLUSIONS: PCV should be differentiated from other causes of choroidal neovascularization using ICG angiography. Although these polypoidal lesions can be stable or even regress spontaneously, hypertension control and laser photocoagulation of the leaky vessels may help preserve the vision in some patients.
Affiliation of Co-Authors New England College of Optometry
Outline