Replacement of polyps with type 1 macular neovascularization in polypoidal choroidal vasculopathy imaged with swept source OCT angiography

Mengxi Shen; Qiyu Bo; Minlu Song; Xiaoshuang Jiang; Zohar Yehoshua; Giovanni Gregori; Xiaodong Sun; Fenghua Wang; Philip J Rosenfeld

doi:10.1016/j.ajoc.2021.101057

Replacement of polyps with type 1 macular neovascularization in polypoidal choroidal vasculopathy imaged with swept source OCT angiography

Am J Ophthalmol Case Rep. 2021 Mar 11:22:101057. doi: 10.1016/j.ajoc.2021.101057. eCollection 2021 Jun.

Authors

Mengxi Shen¹, Qiyu Bo², Minlu Song², Xiaoshuang Jiang^{1

3}, Zohar Yehoshua¹, Giovanni Gregori¹, Xiaodong Sun^{2

4

5

6

7}, Fenghua Wang^{2

4

5

6

7}, Philip J Rosenfeld¹

Affiliations

¹ Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
² Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.
⁴ National Clinical Research Center for Eye Diseases, China.
⁵ Shanghai Key Laboratory of Ocular Fundus Diseases, China.
⁶ Shanghai Engineering Center for Visual Science and Photomedicine, China.
⁷ Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, China.

Abstract

Purpose: To investigate the morphological changes of polyps in eyes with polypoidal choroidal vasculopathy (PCV) after treatment with vascular endothelial growth factor (VEGF) inhibitors using swept source optical coherence tomography angiography (SS-OCTA).

Observations: Following anti-VEGF therapy, polyps were found to evolve into typical type 1 macular neovascularization (MNV) in five eyes. In all of these five eyes, a polypoidal lesion was detected adjacent to a serous or hemorrhagic retinal pigment epithelial detachment (PED).

Conclusions and importance: Polypoidal lesions in PCV can evolve into typical type 1 MNV. This morphological evolution suggests that these polyps are clusters of tangled vessels that can proliferate into a more typical neovascular pattern, and this evolution may be facilitated by being adjacent to a PED. Since this morphological appearance could be associated with a better prognosis, SS-OCTA might be helpful in identifying cases of transformed polyps that may be associated with a decreased risk for vision loss.

Keywords: Anti-vascular endothelial growth factor treatment; Polyp; Polypoidal choroidal vasculopathy; Swept source OCT angiography; Type 1 macular neovascularization.

Publication types

Case Reports