Polypoidal choroidal vasculopathy: an angiographic discussion.
1National Healthcare Group Eye Institute, Singapore, Singapore. Tock_han_lim@nhg.com.sg
Eye (London, England)
|January 16, 2010
Summary
Polypoidal choroidal vasculopathy (PCV) presents unique features, differing from typical age-related macular degeneration. Research suggests PCV may benefit from combined therapies targeting its distinct vascular network.
Area of Science:
- Ophthalmology
- Medical Imaging
- Vascular Biology
Background:
- Polypoidal choroidal vasculopathy (PCV) understanding has evolved significantly over 30 years.
- Hallmark: typical hyperfluorescent nodules on indocyanine green angiography (ICGA).
- Clinical presentation overlaps with exudative age-related macular degeneration (AMD) and choroidal neovascularization (CNV).
Purpose of the Study:
- To differentiate PCV from exudative AMD secondary to CNV.
- To explore the potential of combination therapy for PCV.
- To highlight the need for PCV to be studied as a distinct entity.
Main Methods:
- Confocal scanning laser ophthalmoscopy indocyanine green dynamic angiography used to study vascular networks.
- Comparison of clinical and angiographic features with exudative AMD and CNV.
- Review of treatment responses to photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF) therapy.
Main Results:
- PCV exhibits feeder vessels, branching patterns, and leakage similar to CNV.
- PCV shows a seemingly better natural history and response to PDT compared to CNV.
- PCV demonstrates incomplete response to anti-VEGF therapy alone.
Conclusions:
- PCV may be a distinct vascular subtype of exudative AMD, warranting separate study.
- Combination therapy (PDT + anti-VEGF) may offer synergistic benefits for PCV.
- Results from the EVEREST trial are anticipated to clarify optimal treatment strategies.
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