441 Vasculopathie polypoïdale choroïdienne : Comment traiter ?

Abstract

Polypoidal choroidal vasculopathy is a disease with characteristic choroidal vascular abnormalities. Although the polypoidal choroidal vasculopathy and age-related macular degeneration have been known to share common genetic factors, clinical characteristics suggest that polypoidal choroidal vasculopathy is a separate clinical entity from age-related macular degeneration. Indocyanine green angiography is essential for diagnosis. The prevalence is higher in Asian people than in Caucasians. In some cases, a spontaneous resolution can occur with no treatment at all. The results of photodynamic therapy for polypoidal choroidal vasculopathy are encouraging. The lower efficacy of Bevacizumab has been shown for polypoidal choroidal vasculopathy Recurrence may affect vision over time. Two females of 50 and 75 years old with subacute visual loss were examined. ICG angiography demonstrates the presence of polypoidal choroidal vasculopathy. In one case the polypoidal lesion disappears without treatment. The other case is treated with focal PDT showing a complete resolution of the lesion. The visual acuity in both cases is recovered partially and it is stable 9 months later with no recurrence of the lesion. As Polypoidal choroidal vasculopathy has a difficult management, when the polypoidal lesion is out of the fovea, it is fair to wait and see its behaviour. In case treatment is needed, the PDT is the best option. The way to manage Polypoidal Choroidal Vasculopathy remains controversial. Several treatments have been used but at the moment observation or PDT is the best option. A treatment that stops recurrences is not available yet.