Multimodality imaging in diagnosing polypoidal choroidal vasculopathy.

PURPOSE Report a case of polypoidal choroidal vasculopathy (PCV) and reveal its characteristics in multispectral imaging (MSI), a novel modality that examines individual retinal layers and enhances visualization of deep retinal structures. CASE REPORT A 60-year-old Chinese woman presented with blurred vision in her left eye for over 1 week. Fundus examination revealed massive subretinal hemorrhage in the posterior pole with reddish orange polyp-like structure on the fovea of the left eye. Optical coherence tomography showed classic hyperreflectivity in the choroidal layer, known as the "double-layer" sign, adjacent to a serous retinal pigment epithelial detachment, which was further confirmed in fluorescein angiography of the left eye. Indocyanine green angiography demonstrated the features of PCV, including multiple polyps arising out of inner choroidal vessels in the early phase as hyperfluorescent spots and ringlike silhouette staining of the polyps in the late phase. Multispectral imaging as a new modality was introduced to visualize the polypoidal lesion as a polyp-like cluster of hyperreflectance in the short-wavelength images (green and yellow) with subsequent highly defined ringlike hyperreflectance in the longer-wavelength images (near-infrared and infrared). According to the manifestations above, this patient's final diagnosis was PCV in the left eye. CONCLUSIONS This is the first report using MSI as a novel imaging modality for the detection of PCV. Multispectral imaging can reveal highly defined hyperreflective polyp-like structures in the longer-wavelength images, which is compatible with the indocyanine green angiography findings, indicating preliminarily the advantages of noninvasiveness, simplicity, and effectiveness of MSI in diagnosing PCV.