Optical Coherence Tomography as an Alternative for Diagnosing Polypoidal Choroidal Vasculopathy in Developing Countries

Abstract

<i>Introduction: </i>Polypoidal choroidal vasculopathy (PCV) is a variant of neovascular age-related macular degeneration (nAMD). In clinical practice, PCV is frequently differentiated from nAMD or other retinal diseases using imaging modalities like optical coherence tomography, especially in ophthalmology clinics and hospitals which do not have access to indocyanine green angiography (ICGA), the gold standard in diagnosing PCV. As such, definite diagnosis of PCV is not possible in some cases and the actual prevalence of PCV remains unknown. <i>Case series presentation: </i>We have described a report of four patients without significant past medical history who presented with acute central or paracentral scotoma caused by PCV. Our approach to diagnosing PCV relied on the clinical manifestations of fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography imaging (SS-OCT). <i>Conclusion: </i>In the absence of ICGA and OCT angiography in developing countries, it is essential to distinguish PCV from other retinal diseases, especially neovascular age-related macular degeneration as the treatment and prognosis of PCV differs from that of other retinal diseases. We believe that the key features observed in FFA and SS-OCT can potentially be equivalent to the findings on ICGA in accurate diagnosis of PCV, which is essential in tailoring patient treatment plans, set expectations, and find more effective and precise solutions.