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Davis, Stephen J. MD; Lauer, Andreas K. MD; Flaxel, Christina J. MD

doi: 10.1097/IAE.0000000000000206
Original Study

Purpose: To report on a series of white patients in the United States with polypoidal choroidal vasculopathy (PCV).

Methods: This is a retrospective chart review of 27 patients at a single center with PCV.

Results: The mean age was 74.3 with 48% being male. The most common presenting diagnosis was exudative age-related macular degeneration in 59%, and it took 17.5 months to diagnose PCV. During this time, patients received one antivascular endothelial growth factor injection every 1.3 months. The most common reason for suspecting PCV was a large retinal pigment epithelial detachment or a poor response to antivascular endothelial growth factor therapy. Once PCV was diagnosed, most underwent photodynamic therapy. In those who received photodynamic therapy, the fluid and/or age-related macular degeneration decreased in 86%. The vision improved in 41% with 36% maintaining stable vision. Patients received only one additional injection every 3.95 months after photodynamic therapy.

Conclusion: This is one of the larger series of PCV in an entirely white population. It emphasizes the importance of diagnosis in whites as PCV can masquerade as recalcitrant exudative age-related macular degeneration. Common findings were a temporal or peripapillary location and the presence of lipid. After photodynamic therapy, the patients still required antivascular endothelial growth factor therapy, but the injection burden was decreased by 67% and vision was found to be improved or maintained in 77% of patients.

Polypoidal choroidal vasculopathy is not just a disease among Asians and can masquerade as exudative age-related macular degeneration in whites. Treatment with photodynamic therapy and antivascular endothelial growth factor therapy is effective and has a similar response as in Asians. The findings of polypoidal choroidal vasculopathy in white-only patients are described.

Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.

Reprint requests: Christina J. Flaxel, MD, Casey Eye Institute, Oregon Health Science University, 3375 SW Terwilliger Boulevard, Portland, OR 97239; e-mail:

Supported in part by an unrestricted grant from the Research to Prevent Blindness.

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.