A Clinically Documented Appearance of Choroidal Polyps in A Patient with AMD: A Case Report

Abstract

AIM: To report the insurgence of a polypoidal choroidal lesions during the follow-up of a type 1 choroidal neovascular membrane (CNV) in an aged-related macular degeneration (AMD) treated with antiangiogenic documented by indocyanine green fluoresceinography (ICGA).

METHODS AND RESULTS: A 69-year-old man with an AMD disciform scar on his left eye developed a CNV type 1 in his right eye. He was treated with three monthly loading doses and PrN ranibizumab for 15 months until changing to aflibercept. Due to the limited response to anti-VEGF treatment we decided to perform an ICGA which showed a CNV without other lesions associated. After another 9 months of continuous treatment the patient developed a macular haemorrhage. We performed a pneumatic displacement and ICGA was repeated showing a polypoidal change in the edge of the CNV (NV-AMD related polyps). Therefore we started a combined treatment with photodynamic therapy and aflibercept injections.

CONCLUSIONS: Polypoidal changes coexisting with a CNV have been documented in a range of different diseases including AMD. Some studies have demonstrated clinical and statistically significant differences between idiopathic polypoidal choroidal vasculopathy (PVC) and NV-AMD–related polyps so they could be considered as distinct entities. But, to our knowledge, this is the first report on NV-AMD-related polyps that documents with ICGA the sequence in which CNV and polyps appear.