Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy

Retina. 2007 Jun;27(5):589-94. doi: 10.1097/01.iae.0000249386.63482.05.


Purpose: To identify the tomographic features of the branching vascular networks in patients with polypoidal choroidal vasculopathy (PCV).

Methods: We prospectively performed third-generation optical coherence tomography (OCT) and fluorescein angiography for 44 eyes of 42 patients (mean age +/- SD, 67.1 +/- 9.1 years) with PCV. All eyes had branching vascular networks and polypoidal lesions that were confirmed by indocyanine green angiography.

Results: OCT showed double reflective layers that consisted of retinal pigment epithelium (RPE) and another highly reflective layer beneath the RPE ("double-layer sign") in the area of the branching network vessels in 26 (59%) of 44 eyes. The remaining 18 eyes had no double-layer sign, but 17 (94%) of 18 eyes had a slightly elevated RPE. A serous retinal detachment was present in 23 (88%) of 26 eyes with a double-layer sign, while only 1 (6%) of 18 eyes without the sign had a serous retinal detachment.

Conclusions: In PCV, the double-layer sign is seen frequently in the area of the network vessels, particularly in eyes with a serous retinal detachment. The sign may reflect fluid accumulation between RPE and Bruch membrane resulting from leakage from the network of abnormal vessels.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bruch Membrane / pathology
  • Capillary Permeability
  • Choroid / blood supply*
  • Choroid Diseases / diagnosis*
  • Coloring Agents
  • Extracellular Fluid
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / diagnosis*
  • Pigment Epithelium of Eye / pathology
  • Prospective Studies
  • Retinal Detachment / diagnosis
  • Tomography, Optical Coherence*


  • Coloring Agents
  • Indocyanine Green