Haemorrhagic pigment epithelial detachment as a predictive feature of polypoidal choroidal vasculopathy in a Chinese population

Purpose To determine the frequency of haemorrhagic pigment epithelial detachment (PED) among patients presenting with either polypoidal choroidal vasculopathy (PCV) or choroidal neovascularization (CNV) and calculate the degree to which the presence of a haemorrhagic PED can be used to predict the diagnosis of PCV. Methods A retrospective review of 290 eyes of 253 patients presenting to the Singapore National Eye Centre with serosanguineous maculopathy. Patients underwent ophthalmologic examination including digital colour fundus photography and stereoscopic fluorescein angiography and indocyanine green angiography (ICGA). Classification into PCV or CNV was based on ICGA findings, and presence or absence of haemorrhagic PED was documented. Results In total, 138 eyes of 123 patients were diagnosed with PCV and 152 eyes of 130 patients with CNV. A haemorrhagic PED was a significantly more common (P<0.001) presenting feature in PCV eyes (63, 45.7%) than CNV eyes (6, 3.9%) (odds ratio (OR) 20.4, 95% confidence interval (CI) 8.5-49.4). Age-related maculopathy was found significantly more frequently (P<0.001) in the unaffected fellow eye of CNV patients (57, 52.8%) than PCV patients (28, 22.8%) (OR 3.2, 95% CI 1.8-5.7). Conclusions In patients of Chinese ethnicity, a haemorrhagic PED is significantly more likely to be the presenting feature of PCV than CNV. Patients presenting with this clinical feature should make the clinician suspicious of an underlying diagnosis of PCV. Eye (2010) 24, 789-792; doi:10.1038/eye.2009.214; published online 11 September 2009