Polypoidal choroidal vasculopathy associated with tilted disc syndrome

Purpose: To describe a complication of tilted disk syndrome-macular serous retinal detachment caused by development of polypoidal choroidal vasculopathy. Methods: A 65-year-old patient with visual loss and metamorphopsia was evaluated with fluorescein and indocyanine green angiography (ICG) and optical coherence tomography. Subsequently, photodynamic therapy (PDT) with verteporfin was administered. Results: Fundus examination showed classic features of tilted disk syndrome as well as a unilateral macular serous detachment secondary to a polypoidal lesion, which was clearly outlined by ICG angiography at the site of a macular lacquer crack. The lesion resolved after PDT. Two years after treatment, no recurrence was observed, and visual acuity was 20/25 without distortion. Conclusions: In this patient with tilted disk syndrome, unilateral polypoidal choroidal vasculopathy was diagnosed by ICG angiography and treated successfully with PDT.