A Case of Pachychoroid Spectrum Disorder with a 25 Year Follow Up

Title A Case of Pachychoroid Spectrum Disorder with a 25 Year Follow Up
Author, Co-Author Jerome Sherman, Angela Wen, Ayah Ahamed, Danica Yang, Susan Elrich
Topic Treatment and Management of Posterior Sgmt Disease
Year
2016
Day
Friday
Program Number
165388
Room
Ballroom A-B
Affiliation
State University of New York
Abstract

Introduction:

Central serous chorioretinopathy (CSC) is an ocular condition that results from fluid buildup under the retina leading to a distortion in vision. CSC typically manifests unilaterally but can occur bilaterally. Middle-aged males are at an increased risk of developing CSC, especially those with “type A” personalities. A recent article by Dansingani et al discusses en face imaging of pachychoroid spectrum disorders and demonstrates increased thickness and dilated outer choroidal vessels as a prominent morphological finding in CSC. This report explores the case of a patient with both CSC and polypoidal choroidal vasculopathy (PCV).

Case Report:

A patient presented initially with classic CSC proven with fluorescein angiography (FA) OD. She was diagnosed with PCV a quarter of a century later. During the time, she experienced blurred vision along with small macular hemorrhaging due to choroidal neovasularization. The Rabin Cone test revealed abnormal cone function and contrast sensitivity in the affected eye only. ICG and FA confirmed choroidal neovasularization and polyp-like lesions consistent with a diagnosis of PCV. En face and cross-sectional OCT images demonstrated a thick choroid with dramatically dilated choroidal vessels in the right eye alone. The patient was then treated with multiple intravitreal anti-VEGF injections. During the last follow up, the patient had visual acuities of 20/50 OD and 20/20 OS.

Conclusion:

After a quarter of a century follow up, the newer technology showed new blood vessel formation and bleeding. Analysis of en face and cross-sectional OCT images revealed dilated choroidal vessels. It is possible that choriocapillaris atrophy gives rise to focal ischemia, which drives neovasularization. This case study shares common morphologic findings in CSC including inwardly displaced, pathologically dilated choroidal vessels which occupy full thickness of the choroid.

 

Affiliation of Co-Authors SUNY College of Optometry, SUNY College of Optometry, SUNY College of Optometry, Southampton Hospital
Outline