Polypoidal choroidal vasculopathy: a common type of neovascular age-related macular degeneration in Caucasians.

AIMS: To describe the prevalence of polypoidal choroidal vasculopathy (PCV) in a Caucasian population with neovascular age-related macular degeneration (NAMD). METHODS: All patients referred to a city AMD service over a 2-year period underwent imaging including Indocyanine Green Angiography at baseline. A panel of experts confirmed the patients with NAMD and diagnosed the lesion type including PCV. The proportion of Caucasian patients with PCV was identified. Two authors independently reviewed clinical imaging and recorded data of patients with PCV on lesion characteristics. Further information including treatments received and visual acuity at different time points was analysed. RESULTS: A total of 492 patients were diagnosed with NAMD during the 2-year study period. Of these patients, 204 had occult lesions (41.5%). PCV was identified in 45 patients (22.1% of occult NAMD and 9.1% of all NAMD). 23 patients received anti-vascular endothelial growth factor (VEGF) monotherapy, 8 received verteporfin photodynamic therapy (PDT) monotherapy and the remaining 14 patients were managed with combined PDT and anti-VEGF treatment. CONCLUSIONS: The prevalence of PCV in Caucasians is higher than previously reported. Indocyanine Green Angiography should be a standard investigation for all new patients with NAMD, particularly those with occult NAMD, to avoid missing this important subset.

Persistent visual loss as a complication of meningococcal meningitis.

Meningococcal disease remains a major cause of morbidity and mortality in childhood. Cerebral infarction complicating meningococcal meningitis is recognized but uncommon. We describe a 3-year-old boy with parieto-occipital infarction secondary to meningococcal meningitis, resulting in permanent visual loss as the sole neurologic sequelae and, consequently, major implications for his subsequent development.