A novel classification of the vascular patterns of polypoidal choroidal vasculopathy and its relation to clinical outcomes

Abstract

The PCV subtype seen on initial presentation affects the long-term visual outcomes over a 5-year period.

Intravitreal aflibercept for choroidal neovascularisation in angioid streaks

“…However, the rates of visual loss differed significantly among the three subtypes: 0% for type A PCV, 8.7% for type B, and 35.3% for type C (P = 0.001). 2 A similar pattern was observed over the subsequent 5 years.…”

“…In a study of 107 consecutive patients with PCV, three subtypes of PCV were identified on the basis of the features seen on ICGA and fluorescein angiography. 2 The PCV subtype significantly affected the visual outcome at 5 years. In our series, 21.5% of patients experienced ≥ 0.3 LogMAR unit decrease in visual acuity at 1 year.…”

“…3 To the best of our knowledge this is the first report to describe the clinical benefit of aflibercept for AS-CNV. Moreover, as the one of the major difficulties in treating CNV secondary to AS is recurrence, 2 it may be that aflibercept offers an additional benefit over other anti-VEGF agents as it has a higher affinity for VEGF-A as well as the ability to bind VEGF-B and placental growth factor, resulting in a more effective inhibition of the pathological angiogenic process. 4,5 Further longitudinal studies with a larger cohort of patients are required to verify this hypothesis.…”

“…This study highlights the key role of indocyanine green angiography (ICGA) in the diagnosis and management of PCV. [2][3][4] In addition to the clinical and angiographic features described, it is also important to consider insights from studies that classified PCV into various subtypes. It has been suggested that PCV may not be a single disease entity, but may consist of different subtypes that influence the longterm prognosis.…”

“…1 Treatment options have included laser photocoagulation and photodynamic therapy; 1,2 with the advent of anti-vascular endothelial growth factor (VEGF) therapies, off-label anti-VEGF has become the treatment of choice and both bevacizumab and ranibizumab have been shown to be effective. [1][2][3] We describe the off-label use of 2 mg intravitreal aflibercept in two patients as primary treatment for AS-associated CNV (AS-CNV). …”