Fundus Autofluorescence in Polypoidal Choroidal Vasculopathy

Abstract

To investigate and compare the characteristics of fundus autofluorescence (FAF) in polypoidal choroidal vasculopathy (PCV) with those in typical neovascular age-related macular degeneration (AMD). Retrospective, observational, consecutive case series. Ninety-two patients with PCV (92 affected eyes and 86 unaffected fellow eyes) and 31 patients with typical neovascular occult AMD with no classic choroidal neovascularization (31 affected eyes and 24 unaffected fellow eyes). All study eyes underwent FAF photography with a fundus camera-based system. The incidence and distribution of hypoautofluorescence, that is, the manifestation of retinal pigment epithelium (RPE) damages, were evaluated. The characteristic FAF findings in PCV. In the affected eyes with PCV, the sites of the neovascular lesions showed 2 distinct FAF patterns: (1) the confluent hypoautofluorescence at the polypoidal lesions and (2) the granular hypoautofluorescence at the branching choroidal vascular networks. The confluent hypoautofluorescence, most of which was surrounded by a hyperautofluorescent ring, was seen in 74 eyes (80.4%) with PCV but was seen in no eyes with typical neovascular AMD (P < 0.001). The granular hypoautofluorescence was seen in 91 eyes (98.9%) with PCV and 27 eyes (87.1%) with typical neovascular AMD (P = 0.014). In addition, the eyes with PCV more frequently showed hypoautofluorescence outside the macular area than those with typical neovascular AMD (P = 0.021). In the unaffected fellow eyes, the hypoautofluorescence was more frequently observed in patients with PCV than in those with typical neovascular AMD, inside the macular area and in the entire FAF image (P = 0.012, P = 0.003, respectively). In eyes with PCV, the polypoidal lesions and the branching choroidal vascular networks appeared to affect the RPE and induce peculiar FAF findings. When compared with the patients with typical neovascular AMD, widespread RPE damage was more frequently observed in the patients with PCV, both in the affected eyes and in the unaffected fellow eyes.