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Current management strategy of polypoidal choroidal vasculopathy
Christine P S Ho1, Timothy Y Y Lai2
1Faculty of Medicine, The University of Hong Kong; 2010 Retina and Macula Centre, Kowloon, Hong Kong SAR.
Indian Journal of Ophthalmology
|November 20, 2018
Summary
Polypoidal choroidal vasculopathy (PCV) is a common retinal disorder in Asians. This review updates management strategies for PCV, evaluating recent clinical trials and therapeutic options.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Vascular Biology
Background:
- Polypoidal choroidal vasculopathy (PCV) is a retinal disorder often presenting as neovascular age-related macular degeneration, particularly in Asian populations.
- Characterized by specific clinical signs like serous macular detachment and subretinal hemorrhage, PCV diagnosis traditionally relies on indocyanine green angiography (ICGA).
- Recent advancements in imaging, including spectral domain optical coherence tomography (OCT) and OCT angiography, offer new insights into PCV pathogenesis and its link to pachychoroid disorders.
Purpose of the Study:
- To review and summarize recent literature and clinical trials on polypoidal choroidal vasculopathy (PCV).
- To provide an update on the evolving understanding of PCV pathogenesis and clinical characteristics.
- To propose an overall management strategy for PCV based on current evidence.
Main Methods:
- Literature review of recent studies and multi-center randomized clinical trials (e.g., EVEREST, EVEREST II, PLANET).
- Analysis of diagnostic imaging modalities including ICGA, OCT, and OCT angiography.
- Evaluation of therapeutic options such as anti-VEGF monotherapy, combination therapy, and photocoagulation.
Main Results:
- ICGA remains the gold standard for PCV diagnosis, visualizing characteristic polypoidal vascular lesions.
- High-resolution OCT and OCT angiography have enhanced understanding of PCV pathogenesis and its association with pachychoroid disorders.
- Multiple clinical trials have compared the efficacy and safety of various treatment modalities for PCV.
Conclusions:
- The management of PCV is evolving with a better understanding of its pathogenesis and the availability of diverse therapeutic options.
- Evidence from recent clinical trials guides the selection of treatments, including anti-VEGF therapies and photodynamic therapy.
- An integrated management strategy is crucial for optimizing outcomes in patients with polypoidal choroidal vasculopathy.
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