Polypoidal choroidal vasculopathy: Pearls in diagnosis and management

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Imaging

Background:

• Polypoidal choroidal vasculopathy (PCV) is a significant cause of exudative maculopathy, particularly in Asian populations.
• It is often distinguished from wet age-related macular degeneration, more common in Caucasians.

Purpose of the Study:

• To establish consensus recommendations for the diagnosis, management, and follow-up of PCV.
• To provide guidance for retinal specialists based on a systematic literature review.

Main Methods:

• A panel of retinal experts conducted a methodical evaluation of updated literature on PCV.
• A comprehensive PubMed/MEDLINE search was performed to identify relevant studies.
• Consensus was reached on diagnostic criteria, imaging interpretation, and treatment strategies.

Main Results:

• Indocyanine green angiography (ICGA) is the gold standard for PCV diagnosis, showing characteristic polypoid lesions and abnormal vascular networks (AVN).
• Optical coherence tomography (OCT) serves as an essential adjuvant for diagnosis, monitoring disease activity, and guiding treatment decisions.
• Treatment options include photodynamic therapy, anti-VEGF agents, and thermal laser, with choices influenced by lesion characteristics and disease severity.

Conclusions:

• The consensus recommendations offer a framework for accurate PCV diagnosis using ICGA and OCT.
• Individualized treatment strategies considering various clinical factors are crucial for optimal PCV management.
• These guidelines aim to enhance physician decision-making and improve patient outcomes in PCV.