Choroidal Vascular Anastomosis in Polypoidal Choroidal Vasculopathy and Exudative Age-related Macular Degeneration Patients

Objective To compare the presence of vortex vein anastomosis on indocyanine green angiographies (ICGAs) in patients diagnosed with polypoidal choroidal vasculopathy (PCV) with those of typical exudative age-related macular degeneration (EAMD) patients. Methods We reviewed the medical records, optical coherence tomography (OCT), and autofluorescence of 100 eyes of 50 patients who were referred to our clinic with a diagnosis of EAMD and completed ICGA at our institution. The findings on ICGAs, autofluorescence, and OCT were compared between patients diagnosed with PCV and exudative AMD. Results 62 eyes of 50 patients were included, of which 14 eyes had PCV characteristics on ICGA, 44 had choroidal neovascularization (CNV) without PCV findings, and four had another diagnosis or a normal exam. Anastomosis of large choroidal vessels at the horizontal watershed zone was noted in the ICGA of 5 eyes (35.7%) with PCV compared to 30 eyes (68.2%) diagnosed with CNV without PCV (p = 0.082). OCT finding consistent with the ICGA diagnosis were noticed in 12 (85.7%) eyes with PCV. Conclusions Choroidal vascular anastomosis on ICGA might represent a general characteristic of CNV rather than a specific marker for PCV. Further studies are warranted to understand the significance of this unique finding.