Cross-sectional and en face optical coherence tomographic features of polypoidal choroidal vasculopathy

Purpose: To correlate optical coherence tomography (OCT)-ophthalmoscope images with angiographic signs of polypoidal lesions and branching network vessels in eyes with polypoidal choroidal vasculopathy (PCV). Methods: The authors prospectively examined 50 consecutive eyes with PCV using the OCT-ophthalmoscope and fluorescein and indocyanine green angiography (ICGA). Results: ICGA showed polypoidal lesions in all eyes. In 18 of 22 eyes with a retinal pigment epithelial detachment (PED), OCT-ophthalmoscope cross-sectional B-scan images showed a central dome-shaped PED and a contiguous small PED corresponding to the polypoidal lesions on ICGA. Transverse C-scan images showed an irregularity or protrusion of the highly reflective retinal pigment epithelium (RIDE) line of the PED corresponding to the polypoidal lesions on ICGA in all 22 eyes. In 28 eyes without a PED, the B-scan images showed polypoidal lesions as anterior protrusions of a highly reflective RPE line in 26 of 28 eyes; in those 26 eyes, C-scan images showed distinctive rings of a highly reflective RPE line corresponding to the polypoidal lesions on ICGA. ICGA showed an abnormal vascular network in 41 of the 50 eyes that appeared as a highly reflective area on C-scan images in 32 of the 41 eyes. In 20 of the 41 eyes, B-scan images showed two separate highly reflective RPE lines at the area of the abnormal vascular network. Conclusions: The OCT-ophthalmoscope C-scan images of the irregularity and the protrusion in the PED and the distinctive bright rings in eyes without a PED may be diagnostically important as indicators of polypoidal lesions in eyes with PCV.