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Polypoidal Choroidal Vasculopathy

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Polypoidal choroidal vasculopathy (PCV) is widely considered a variant of type 1 CNV. PCV often presents as serosanguineous maculopathy and large submacular hemorrhage. The PCV lesion complex is often comprised of two parts: polyps and branching vascular network (BVN). Both components typically reside beneath the RPE [10, 11]. On FA, therefore, an occult leakage pattern is typically observed, and is often indistinguishable from type 1 CNV. On ICGA, however, polyps can be seen as focal hyperfluorescent lesions which are often nodular in appearance and appear within the first 6 min after dye injection (Fig. 13). Other associated features include the presence of BVN, hypofluorescent halo around the polyp, pulsatility on dynamic ICGA, or the association of orange subretinal nodule on color photograph or massive submacular hemorrhage. The confocal scanning laser ophthalmoscope (cSLO)-based ICGA platform can acquire higher contrast images compared to flash-camera-based ICGA and has been shown to be superior at detecting BVN [12, 13]. A further advantage of the cSLO-based ICGA system is the ability to acquire videoangiography. This allows further assessment of the dynamic properties of the lesion, including speed and direction of filling. Features that are best evaluated using videoangiography include pulsatility, feeder vessels, and anastomotic vessels as in RAP.

Imaging Techniques

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