A study of laser photocoagulation for polypoidal choroidal vasculopathy.

PURPOSE To evaluate the efficacy of laser photocoagulation for polypoidal choroidal vasculopathy (PCV) involving the macula. METHODS The records of 38 patients (47 eyes) undergoing laser photocoagulation for PCV causing serosanguineous detachment involving the fovea were reviewed and the results were evaluated. Ten eyes underwent photocoagulation to induce a fusion scar covering whole lesions consisting of both abnormal vessels and polypoidal lesions. Thirty-seven eyes underwent photocoagulation for only polypoidal lesions. When serosanguineous detachment recurred, additional photocoagulation was performed, targeting the causative lesions. Photocoagulation was performed with an argon dye laser or multicolor krypton laser. Final visual acuity, macular changes at the final visit, and the number of photocoagulations were evaluated. Follow-up period after the first photocoagulation was at least 1 year. RESULTS Of the 10 eyes undergoing photocoagulation of whole lesions, 9 showed absorption of exudate and/or blood after one photocoagulation, and maintained or improved visual acuity. Of the 37 eyes undergoing laser photocoagulation of only polypoidal lesions, 20 (54%) showed decreased visual acuity because of recurrent or persistent exudation and/or classic choroidal neovascularization or, alternatively, because of atrophy at the fovea; 32 of the 37 eyes had undergone photocoagulation at least twice or more. CONCLUSION Photocoagulation is recommended only for whole lesions.