Polypoidal choroidal vasculopathy (PCV) is a retinal disorder characterized by aneurismal polypoidal lesions in choroidal vasculature. PCV appears to preferentially affect pigmented individuals and is considerably high among Asians. Most reports on patterns of PCV around Asia are based on a homogenous race (e.g. Chinese, Japanese) and very few descriptions from a multiracial population like those seen in Malaysia. The present study aimed to describe the demographic features, clinical and investigative characteristics of PCV in a multiracial group at Universiti Kebangsaaan Malaysia Medical Centre (UKMMC). Ninety one eyes of 86 PCV patients, comprising of Chinese (65.1%), Malays (31.4%), Indians (2.3%) and Eurasian (1.2%) were retrospectively reviewed. All underwent complete ophthalmic examination and investigations. Mean patient age was 70.4 years with a male preponderance (59.3%), and mostly unilateral presentation (94.1%). The logMAR mean presenting visual acuity was 0.78 ± 0.64. Polypoidal vascular lesions were located generally within the macula area (86.8%), manifesting mainly as submacular hemorrhage (59.3%). Interestingly a number of eyes (43.9%) had associated drusen. Optical coherence tomography largely demonstrated exudative changes (75.9%) and almost all patients (97.7%) had loss of external limiting membrane (ELM) and IS/OS interface. On indocyanine green angiography, majority of eyes had multiple polyps (82.4%) with ‘cluster’ (58.2%) being the commonest configuration. In conclusion, although the patterns of PCV in UKMMC were mainly similar to other Asian patients, a number of our patients had associated drusen. This indicates that PCV in our population could be a variant of neovascular age related macular degeneration and not solely idiopathic in nature.
Patterns of Polypoidal Choroidal Vasculopathy among a Multiracial Population in a Malaysian Hospital
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Polypoidal choroidal vasculopathy (PCV) adalah penyakit retina yang dicirikan oleh aneurismal polip dalam salur darah koroid. Penyakit PCV kerap berlaku dikalangan populasi yang berpigmen terutama di kalangan orang Asia. Kebanyakan laporan mengenai corak penyakit PCV disekitar Asia hanya berdasarkan satu bangsa sahaja (e.g. kaum Cina, Jepun). Amat sedikit laporan mengenai corak penyakit ini dalam populasi pelbagai bangsa seperti di Malaysia. Oleh itu, kajian ini bertujuan menggambarkan ciri-ciri demografi, klinikal dan penyiasatan PCV dalam populasi pelbagai bangsa di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Ini adalah kajian retrospektif pada 91 mata dari 86 pesakit PCV, terdiri daripada Cina (65.1%), Melayu (31.4%), India (2.3%) dan Eurasian (1.2%). Semua pesakit telah menjalani pemeriksaan oftalmik dan penyiasatan terperinci. Purata umur pesakit adalah 70.4 tahun, kebanyakannya lelaki (59.3%) dan majority mengalami masalah didalam satu mata sahaja (94.1%). Purata penglihatan adalah log MAR 0.78 ± 0.64. Luka-luka vaskular polypoidal umumnya didapati dalam kawasan makular (86.8%) dan menunjukkan pendarahan terutamanya dibawah lapisan makular (59.3%). Menariknya, beberapa mata (43.9%) menunjukkan "drusen”. Optikal kepaduan tomografi kebanyakannya menunjukkan perubahan eksudatif (75.9%) dan hampir semua pesakit (97.7%) mempunyai kehilangan membran pengehad external (ELM) dan IS/OS. Dengan ICG angiografi, kebanyakan mata didapati ada lebih dari satu polip (82.4%) dan konfigurasi polip yang paling kerap adalah dalam bentuk ‘kelompok’ (58.2%). Kesimpulannya, walaupun secara amnya corak PCV di PPUKM sama dengan corak PCV dipopulasi Asia yang lain, namun beberapa pesakit mempunyai "drusen”. Oleh itu, PCV di Malaysia mungkin berlainan dengan populasi Asia lain dimana ia mungkin adalah varian degenerasi makular dan tidak idiopatik semata-mata.
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