Polyp clusters: atypical presentation of polypoidal choroidal vasculopathy using OCT angiography.

A 65-year-old Asian female was referred to our department for a second opinion. (A) Indocyanine green angiography of her left eye showed multiple round hyperfluorescent lesions in the intermediate phase suggestive of polypoidal choroidal vasculopathy. (B) A swept-source optical coherence tomography angiography (OCTA) en face flow image disclosed a high-flow network with aneurysmal dilations and a branching vascular network. The corresponding B-scan with flow overlay (C–G) reveals multiple cluster-like polyps attached to the posterior side of the retinal pigment epithelium. Note that the polyps are better visualized with indocyanine green angiography than with en face OCTA. However, this case effectively illustrates the benefits of the OCTA B-scan flow overlay, which clearly shows the individual aneurysms with flow on the underside of the retinal pigment epithelium.