To investigate the prevalence of polypoidal choroidal vasculopathy in presumed age-related peripapillary subretinal neovascular membranes.

Background: To investigate the prevalence and angiographic appearances of polypoidal choroidal vasculopathy (PCV) masquerading as age-related peripapillary subretinal neovascular membranes (PSRNVM).

Methods: A consecutive case series of all patients investigated for presumed age-related PSRNVM in our tertiary referral centre over the period September 2006-2007. The presenting clinical features and fundus fluorescein angiographic (FFA) characteristics of each patient's lesion were identified. Any accompanying Indocyanine Green Angiogram (ICGA) was also reviewed, and on the basis of this investigation patients were classified into one of three groups: proven PCV, probable PCV and PSRNVM.

Results: Thirty patients with presumed age-related PSRNVM were identified. The FFA leakage pattern was occult in 21 patients and classic in nine patients. Sixteen patients also had ICGA performed. In 14 of these patients the original FFA leakage pattern was occult, and in two it was classic. Of the 14 patients with occult leakage on FFA who subsequently underwent ICGA all were found to have PCV.

Conclusions: PCV is important and underrecognized in presumed age-related PSRNVMs. In such cases, particularly when the pattern of leakage on the fluorescein angiogram is occult, ICGA should be performed to identify the site of the polyps and if required to direct treatment.