PMID- 24162896
OWN - NLM
STAT- MEDLINE
DCOM- 20140225
LR  - 20220330
IS  - 1538-9235 (Electronic)
IS  - 1040-5488 (Linking)
VI  - 90
IP  - 12
DP  - 2013 Dec
TI  - The "double-layer sign": in vivo imaging of polypoidal choroidal vasculopathy.
PG  - e293-300
LID - 10.1097/OPX.0000000000000079 [doi]
AB  - PURPOSE: Polypoidal choroidal vasculopathy (PCV), a disease of the choroidal 
      vascular network, presents clinically with polyp-like reddish orange lesions, as 
      well as retinal pigment epithelial (RPE) and/or neurosensory retinal detachments. 
      Optical coherence tomography (OCT) is a useful diagnostic tool that provides 
      cross-sectional and volumetric imaging of posterior segment microstructure. 
      Typical OCT findings in PCV may reveal a classic hyperreflectivity in the 
      choroidal layers known as the "double-layer" sign. This sign is indicative of an 
      abnormal choroidal vascular network. Indocyanine green angiography is also useful 
      for the diagnosis of PCV and clearly identifies the polyp-like lesions arising 
      from the choroidal vasculature. CASE REPORT: A 53-year-old African American woman 
      presented with complaints of gradually decreasing vision in the left eye (OS). 
      Clinical examination revealed moderately reduced acuity OS with a small central 
      scotoma found on Amsler grid testing. Dilated fundus examination revealed a 
      hemorrhagic RPE detachment with suspicion of a choroidal neovascular membrane in 
      the foveal region of the OS. Exudative leakage appeared circumferentially around 
      the macula OS. Optical coherence tomography of the OS also revealed two highly 
      reflective layers: one at the level of the RPE and another beneath the RPE 
      ("double-layer" sign). The patient was referred to a retina subspecialist for 
      angiography and treatment consideration. CONCLUSIONS: It is important to 
      distinguish PCV from other variants of choroidal neovascularization. The 
      polyp-like lesions found in the PCV are a unique and classic characteristic. 
      Proper diagnostic workup includes stereoscopic posterior fundus evaluation and 
      imaging studies, including OCT and indocyanine green angiography.
FAU - St Martin, Jamie M
AU  - St Martin JM
AD  - *OD daggerOD, FAAO Nova Southeastern University, Fort Lauderdale, Florida.
FAU - Rodman, Julie
AU  - Rodman J
FAU - Pizzimenti, Joseph J
AU  - Pizzimenti JJ
FAU - Duchnowski, Eva
AU  - Duchnowski E
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Optom Vis Sci
JT  - Optometry and vision science : official publication of the American Academy of 
      Optometry
JID - 8904931
SB  - IM
MH  - Choroid/blood supply
MH  - Choroidal Neovascularization/*diagnosis
MH  - Female
MH  - Fluorescein Angiography
MH  - Fundus Oculi
MH  - Humans
MH  - Middle Aged
MH  - Polyps/*diagnosis
MH  - Retinal Detachment/diagnosis
MH  - Scotoma/diagnosis
MH  - Tomography, Optical Coherence/*methods
MH  - Visual Acuity
EDAT- 2013/10/29 06:00
MHDA- 2014/02/26 06:00
CRDT- 2013/10/29 06:00
PHST- 2013/10/29 06:00 [entrez]
PHST- 2013/10/29 06:00 [pubmed]
PHST- 2014/02/26 06:00 [medline]
AID - 10.1097/OPX.0000000000000079 [doi]
PST - ppublish
SO  - Optom Vis Sci. 2013 Dec;90(12):e293-300. doi: 10.1097/OPX.0000000000000079.