Large and medium choroidal vessel remodelling in progressive age-related macular degeneration and polypoidal choroidal vasculopathy

PURPOSE: To describe the long-term follow-up of large and medium-sized choroidal vessels in eyes with age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). METHODS: This was a retrospective, observational analysis of eyes with AMD or PCV, with a minimum of five years of follow-up of indocyanine green angiography (ICGA). Qualitative analysis of the choroidal vessels was carried out at baseline until the final visit. RESULTS: We analysed ten eyes of five patients diagnosed with either AMD or PCV with a follow-up duration ranging from seven to sixteen years. Eyes with active disease received various treatment modalities. On serial follow-up of ICGA images, remodelling of medium and large choroidal vessels was seen. The changes included large choroidal vessel attenuation, prominence/ dilatation of pre-existing choroidal vessels connecting the neovascular complex and formation of new anastomotic channels. These changes appeared adjacent to present or future neovascular complex locations. One uninvolved fellow eye showed minimal changes on follow-up. CONCLUSION: We report the long-term changes in large and medium-sized choroidal vessels in eyes with AMD and PCV with serial ICGA images. These vascular alterations suggest the possible role played by these vessels in the pathogenesis of choroidal neovascular complexes.