Can the Origin of Polypoidal Choroidal Vasculopathy Be Revealed by High Resolution OCT?

1. Young-Gyun Kim¹
2. Youngkook Kim¹
3. Eung-Suk Kim²
4. Seung-Young Yu³
5. Hyung-Woo Kwak³

¹Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
²Department of Ophthalmology, Chung-Ang University Yongsan Hospital, Seoul, Korea
³Department of Ophthalmology, KyungHee University Medical Center, Seoul, Korea

Purpose: To determine the origin of polypoidal choroidal vasculopathy (PCV) lesions using high resolution optical coherence tomography (OCT).

Methods: High definition (HD) spectral domain optical coherence tomography (SD-OCT) and a combination spectral optical coherence tomography (OCT) and scanning laser ophthalmoscope (SLO) system (OCT-SLO) were used to obtain retinal cross sectional images from 24 eyes of 24 patients with the clinical diagnosis of PCV. We present four case studies to illustrate the location of PCV lesions in relation to Bruch's membrane.

Results: High resolution OCT images revealed polypoidal lesions and/or abnormal vascular lesions between the detached retinal pigmented epithelium (RPE) and Bruch`s membrane. Bruch`s membrane was seen as a highly reflective line between the RPE and the choroid.

Conclusions: We determined that PCV lesions were located between the RPE layer and Bruch`s membrane. Choroidal neovascularization is located on the outer retina penetrating Bruch`s membrane. Therefore, we suggest that PCV is a form of choroidal neovascularization.