PCV: A Disease of Choroid or Bruch Membrane? Evidence from a Submacular Surgery

Polypoidal choroidal vasculopathy (PCV) is generally regarded as an inner choroidal lesion, but this particular case suggests it might be a pathology of the Bruch membrane. A 62-year-old woman presented with massive subretinal hemorrhage without obvious orange lesion. Preop OCT suggested a typical PCV. No CNV was found during surgery. The video shows that the exact location of the polyp is wrapped within the abnormal Bruch membrane instead of the choroidal capillary and shows it was removed. Postop histopathology confirmed that the polyp was composed of neovessels and structure-free materials, staining positive for CD-34, which is a marker of neovascular expression. Yet we still need more evidence and cases to support our hypothesis for better understanding of PCV entity.