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Polypoidal Choroidal Vasculopathy: Definition, Pathogenesis, Diagnosis, and Management
Chui Ming Gemmy Cheung1, Timothy Y Y Lai2, Paisan Ruamviboonsuk3
1Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS Medical School, National University of Singapore, Singapore, Republic of Singapore.
Ophthalmology
|January 15, 2018
Summary
Polypoidal choroidal vasculopathy (PCV), an age-related macular degeneration subtype, has unclear optimal treatment. Recent trials offer evidence guiding therapy choices for this condition, particularly in Asian populations.
Area of Science:
- Ophthalmology
- Macular Degeneration Research
- Vascular Biology
Background:
- Polypoidal choroidal vasculopathy (PCV) is a subtype of age-related macular degeneration (AMD), prevalent in Asian populations.
- Treatment strategies for PCV remain debated due to differing responses to anti-VEGF agents compared to typical AMD.
- Emerging research links PCV to pachychoroid spectrum disorders, implicating choroidal circulation disturbances.
Purpose of the Study:
- To review recent advancements in understanding PCV epidemiology, pathogenesis, and diagnostic imaging.
- To analyze key findings from recent large-scale clinical trials on PCV treatments.
- To propose evidence-based management guidelines for PCV.
Main Methods:
- Review of current literature on PCV.
- Analysis of data from recent multicenter randomized clinical trials comparing anti-VEGF monotherapy and combination therapy with photodynamic therapy (PDT).
- Synthesis of information from advanced imaging techniques like OCT angiography.
Main Results:
- Two major clinical trials provide level I evidence on the safety and efficacy of different treatment regimens for PCV.
- Advances in imaging have improved PCV diagnosis and understanding of its pathogenesis.
- The review synthesizes findings to guide clinical decision-making.
Conclusions:
- Recent clinical trials offer crucial evidence for selecting optimal treatments for PCV.
- Current management guidelines are proposed based on the latest research findings.
- Further research is needed to address PCV recurrence, polyp closure significance, and heterogeneity.
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