Polypoidal Choroidal Vasculopathy in Highly Myopic Eyes with Elongated Axial Length

Gregg T. Kokame1, 5, *, Elysse S. Tom5, Jessica G. Shantha2, 4, 6, Kyle N. Kaneko2, 4
1 Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, 651 IIalo St. Honolulu, HI, 96813, USA
2 The Retina Center at Pali Momi, 98-1079 Moanalua Road, Suite 470, Aiea, HI 96701, USA
3 Retina Consultants of Hawaii, 98-1079 Moanalua Road, Suite 470, Aiea, HI 96701, USA
4 Hawaii Macula and Retina Institute, 98-1079 Moanalua Road, Suite 410, Aiea, HI 96701, USA
5 John A. Burns School of Medicine, University of Hawaii School of Medicine, 651 Ilalo St, Honolulu, HI 96813, USA
6 Department of Ophthalmology, Emory University, Emory Eye Center, Atlanta, Georgia

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Creative Commons License
© 2017 Kokame et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Hawaii Macula and Retina Institute, 98-1079 Moanalua Road, Suite 470, Aiea, Hawaii, 96701, USA; Tel: 1-808-4878928; Fax: 1-808-4873699; E-mail



To retrospectively review the prevalence of myopia and elongated axial length in eyes with polypoidal choroidal vasculopathy (PCV) and to evaluate treatment response of PCV in highly myopic eyes. PCV has rarely been reported in myopic eyes.


A retrospective review of all eyes diagnosed with PCV at the clinics of Retina Consultants of Hawaii and the Hawaii Macula and Retina Institute was performed between February of 2007 and April of 2017 to evaluate for eyes with significant myopia and elongated axial length.


A total of 282 eyes were diagnosed with PCV by ICG angiography. There were 144 males (59%) and 99 females (41%). 204 patients had unilateral PCV and 39 patients had bilateral PCV. A total of 3 patients with PCV had significant myopia less than -6 diopters or confirmed elongated axial length. One of these patients had bilateral PCV so there were 4 eyes noted with significant myopia and elongated axial length out of 282 eyes with PCV (1.4%). All 3 patients were Asian and presented with active leakage or bleeding related to PCV diagnosed on indocyanine green angiography and optical coherence tomography. Treatments typically used to treat PCV including intravitreal antiangiogenic medications and photodynamic therapy were utilized.

Conclusion and Importance:

High myopia is rare in eyes diagnosed with PCV, even though choroidal neovascularization is a common cause of vision loss in myopic macular degeneration. However, even in highly myopic eyes, PCV may show signs of resistance to antiangiogenic medications.

Keywords: Polypoidal choroidal vasculopathy, High Myopia, Exudative macular degeneration, Photodynamic Therapy, Indocyanine Green Angiography, Bevacizumab, Aflibercept, Ranibizumab.