Sir,

It is widely accepted that polypoidal choroidal vasculopathy (PCV) represents a subtype of subretinal vascular membrane secondary to age-related macular degeneration (AMD).1 We studied the prevalence and epidemiological features of PCV in indocyanine green videoangiography (IGV) for patients with exudative maculopathy and presumed diagnosis of AMD.

Comment

Of 681 consecutive IGVs (after the approval of Institutional Review Board) for exudative maculopathy with presumed diagnosis of AMD, 78 eyes of 72 patients (10.6%) had unequivocal PCV. Six (8.3%) patients had bilateral disease, 48 (66.6%) were women, and the mean age was 73±9.7 years. Drusen were present in nine eyes (11.5%). The most frequent clinical presentation was exudative (70.5%), followed by haemorrhagic (16.7%), combined exudative and haemorrhagic (10.3%) and fibrous scarring (2.6%). The most common PCV morphologic pattern was the cluster-like with connecting network (46.2%), followed by solitary (24.4%), multiple dilations (19.2%), and the cluster-like without connecting network (10.3%). The majority of the lesions were located in the macula (67.9%). Peripapillary lesions were seen in 18 eyes (23.1%). Only subgroups with at least 10 eyes were taken into consideration for statistical analysis (Table 1).

Table 1 Studied relations in patients with polypoidal choroidal vasculopathy
Full size table

Yannuzi et al1 reported a 7.8% rate of PCV in IGV for 167 suspects of exudative AMD. In addition, Kwok et al2 found PCV in 9.3% of Chinese patients and Ladas et al3 described 8.2% of PCV among elderly white Greeks (Table 2). In our study, only unequivocal cases were included, thus raising the possibility that we underestimated the true prevalence of PCV or overestimated the patterns and locations by including these cases.

Table 2 Frequency of polypoidal choroidal vasculopathy found in indocyanine green videoangiography of exudative age-related macular degeneration suspects of different nations
Full size table

In conclusion, PCV was diagnosed in 10.6% of patients referred for IGV in a southeastern Brazilian population, more commonly in elderly females with exudative clinical presentation, macular location, and cluster-like pattern. Data regarding ethnicity are not available because it is an issue of much controversy in Brazil due to enormous racial diversity and miscigenation.