Polypoidal Choroidal Vasculopathy - Symptoms, Causes, and Treatment

Polypoidal Choroidal Vasculopathy (PCV) can lead to serious vision complications if not properly managed. Listed practices with Specialty Vision offer specialized care to address PCV and support your eye health comprehensively.

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Polypoidal Choroidal Vasculopathy & Epidemiology, Demographics, and Causes of PCV & Who Is Affected by PCV?

Polypoidal Choroidal Vasculopathy (PCV) is an eye condition that affects the deep blood vessels in the choroid, the layer beneath the retina. It is marked by the presence of polyp-like swellings, small, balloon-shaped dilations, that form on abnormal branching blood vessels. These changes can cause damage to the retinal pigment epithelium and nearby tissues, sometimes leading to fluid leakage or bleeding under the retina.

Polypoidal Choroidal Vasculopathy (PCV) affects a wide range of people, though it is most commonly seen in adults between the ages of 50 and 65. While earlier reports suggested a higher prevalence among middle-aged Black women, more recent data show that both men and women across different ethnicities can develop the condition.

  • In Asian populations, especially in countries like Japan, PCV is significantly more common, found in 23% to 54% of patients initially diagnosed with age-related macular degeneration (AMD).
  • In Caucasian populations, the prevalence is lower, ranging from 4% to 9.8%.

What Causes PCV? & Signs and Symptoms of Polypoidal Choroidal Vasculopathy (PCV) & Common Symptoms

The exact cause of PCV isn’t fully understood, but it is believed to stem from abnormal changes in the choroidal blood vessels, the network beneath the retina. In PCV:

  • Blood vessels in the choroid become dilated and form small, polyp-like bulges.
  • These weakened vessels may leak fluid or bleed, affecting the surrounding layers of the retina, particularly the retinal pigment epithelium (RPE).

PCV can be subtle in its early stages, but certain signs and symptoms may point to its presence. Patients often notice changes in their vision that gradually worsen over time.

  • Blurred or dim vision in one eye
  • Central or paracentral scotoma – a blurry or dark spot near the center of vision
  • Distortion or waviness in straight lines (metamorphopsia)
  • Fluctuating vision or sudden changes in brightness or contrast

What Doctors May See on Exam & Management Strategies for Polypoidal Choroidal Vasculopathy (PCV) & Medical Treatment Options

During a detailed retinal exam, eye specialists may detect:

  • Orange-red, polyp-like lesions budding from the choroid layer
  • Serous or hemorrhagic retinal detachments (fluid or blood under the retina)
  • Hard exudates, yellowish deposits from leaking blood vessels
  • In rare cases, vitreous hemorrhage, which can cause sudden, significant vision loss

Treating PCV focuses on reducing abnormal blood vessel growth and fluid leakage to preserve vision. While there isn’t a one-size-fits-all treatment, strong clinical evidence supports a combination of therapies for best outcomes.

Combination Therapy (Photodynamic Therapy + Anti-VEGF Injections)

  • This is one of the most effective strategies for managing PCV.
  • The EVEREST trial showed that combining photodynamic therapy (PDT) with anti-VEGF injections led to a significantly higher rate of complete polyp regression than anti-VEGF treatment alone.

Anti-VEGF Monotherapy

  • Studies like the LAPTOP and PLANET trials found that anti-VEGF injections alone can stabilize vision and reduce fluid buildup.
  • However, they may not fully eliminate polyps in many cases, making combination therapy more effective in select patients.

Photodynamic Therapy (PDT)

  • PDT uses a light-activated drug to selectively seal off the abnormal blood vessels beneath the retina.
  • It works well to shrink or close off polyp-like lesions, especially when used with anti-VEGF.

Focal Laser Treatment

  • In rare cases, when the lesions are small and located away from the central vision, traditional laser therapy may be used to seal leaking vessels.

If you're experiencing vision changes or have concerns about Polypoidal Choroidal Vasculopathy, don't hesitate to reach out. Find a top optometrist or ophthalmologist near you listed with Specialty Vision today for a thorough examination and tailored management options.

Ongoing Monitoring and Follow-Up & Complications and Prognosis & Disease Complications

Managing PCV requires long-term care. Even after initial treatment, patients need regular eye exams and imaging tests (such as OCT and ICGA) to monitor for:

  • Reaccumulation of subretinal fluid
  • Recurrence of polyps or hemorrhages
  • Signs of pigment epithelial detachment or scarring

Polypoidal Choroidal Vasculopathy is a condition that can exhibit a range of complications depending on the severity and extent of the disease process. One of the more significant concerns is the development of subretinal fibrosis. This occurs following the resolution of acute serosanguineous events and may result in lasting pigment epithelial changes, including hyperplasia and atrophic degeneration. While these changes are worrisome, studies have shown that even in patients with prolonged disease, timely intervention can halt the progression of vision decline.

Other complications may include:

Recurring Hemorrhages  & Exudative Changes  & Subretinal Fibrosis 

Frequent bleeding under the retina can lead to ongoing visual disturbances.

Leakage from the abnormal vessels often results in fluid accumulation, which may distort the normal retinal architecture.

Over time, the healing process can produce scar tissue that may compromise retinal function, particularly if the macula is involved.

Polypoidal Choroidal Vasculopathy - Symptoms, Causes, and Treatment

If you're experiencing vision changes or have concerns about Polypoidal Choroidal Vasculopathy, don't hesitate to reach out. Find a top optometrist or ophthalmologist near you listed with Specialty Vision today for a thorough examination and tailored management options.

Common Questions

Polypoidal Choroidal Vasculopathy is a condition where abnormal blood vessels form under the retina, leading to potential vision loss.
PCV is most commonly seen in adults aged 50 to 65, with a higher prevalence in Asian populations compared to Caucasians.
Common symptoms of PCV include blurred vision, dark spots in vision, distortion of straight lines, and fluctuating vision.
Treatment often involves a combination of anti-VEGF injections and photodynamic therapy to manage the condition and preserve vision.
Long-term management includes regular monitoring through eye exams and imaging tests to detect recurrences or complications.
Complications from PCV may include recurring hemorrhages, exudative changes, and subretinal fibrosis, which can affect vision.
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Polypoidal Choroidal Vasculopathy - Symptoms, Causes, and Treatment

Polypoidal Choroidal Vasculopathy (PCV) affects vision severely. Discover symptoms, causes, and treatment options from top eye care specialists.

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