Researchers in China investigated the diagnostic accuracy of noninvasive multimodal imaging methods in diagnosing polypoidal choroidal vasculopathy (PCV) and distinguishing it from typical wet AMD. They found that fundus photography and B-scan OCT in particular provide high sensitivity and specificity for diagnosing PCV and distinguishing PCV from typical wet AMD.

The retrospective study assessed the fundus photographs, B-scan OCT, en face OCT, OCT angiography and autofluorescence of 103 eyes with PCV or wet AMD and identified five potential diagnostic features for PCV:

  1. subretinal orange nodule on fundus photography
  2. thumb-like pigment epithelial detachment (PED) on OCT
  3. notched PED on OCT
  4. bubble sign on OCT
  5. Bruch’s membrane depression under serosanguinous PED on OCT

When at least two out of the five features were present on fundus photographs and OCT, there was 0.88 sensitivity and 0.92 specificity for diagnosing PCV.

The researchers noted that clinics in most areas in the world would have quick and easy access to noninvasive multimodal imaging, and they could routinely perform fundus photography and OCT in lieu of more invasive indocyanine green angiography.

Yang J, Yuan M, Wang E, et al. Noninvasive multimodal imaging in diagnosing polypoidal choroidal vasculopathy. BMC Ophthalmol. November 19, 2019. [Epub ahead of print].