Beyond Typical AMD: A Vodcast Exploring the Clinical and Therapeutic Landscape of PCV

Polypoidal choroidal vasculopathy (PCV) is a vascular disease of the choroid characterized by polypoidal lesions and a branching vascular network, leading to recurrent exudation and hemorrhage. It is a major cause of visual disability and is particularly prevalent in Asian populations. PCV is similar to neovascular age-related macular degeneration (nAMD) in morphological characteristics but is increasingly recognized as part of the pachychoroid disease spectrum, although consensus has yet to be reached. Despite overlapping features with nAMD, PCV demonstrates distinct pathophysiology and treatment response, necessitating accurate differentiation for management optimization. Diagnosis relies on multimodal imaging, with indocyanine green angiography (ICGA) as the gold standard, supported by optical coherence tomography (OCT) and OCT angiography. Anti-vascular endothelial growth factor (VEGF) therapy is the mainstay of treatment; however, responses are heterogeneous and are often suboptimal or incomplete. Long-term outcomes are frequently influenced by complications such as hemorrhage, fibrosis, and atrophy, highlighting the need for durable disease control. Advances in imaging and a better understanding of pachychoroid biology are enabling more personalized, activity-guided treatment strategies, with the potential to improve long-term outcomes and reduce treatment burden. In this vodcast, Professor Junyeop Lee discusses the key clinical and pathological features of PCV, how it differs from nAMD, and why it remains challenging to diagnose and manage. The discussion also explores evolving diagnostic approaches, current treatment strategies, and emerging directions in PCV care. Vodcast available for this article. Supplementary file1 (MP4 279147 KB).