Morphological Difference of Choroidal Vasculature Between Polypoidal Choroidal Vasculopathy and Neovascular AMD on OCT: From the Perspective of Pachychoroid

Lai, Kunbei; Zhou, Lijun; Zhong, Xiaojin; Huang, Chuangxin; Gong, Yuanyuan; Xu, Fabao; Ma, Li; Chen, Guandi; Cheng, Lin; Lü, Lin; Jin, Chenjin

doi:10.3928/23258160-20181002-13

Cited by 9 publications

(4 citation statements)

References 36 publications

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“…Recent reports have included PCV in the pachychoroid spectrum [27]. The present study confirmed the presence of thick choroids in patients with PCV in Caucasians, as previously described in Asians [28].…”

Section: Discussionsupporting

confidence: 91%

Polypoidal Choroidal Vasculopathy in Caucasians: Morphological Findings from Multimodal Retinal Imaging

Simão¹,

Farinha²,

Marques³

et al. 2021

Ophthalmologica

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Purpose: To characterize the morphological features of polypoidal choroidal vasculopathy (PCV) in a large Caucasian population. Methods: A multicenter, cross-sectional study of treatment-naïve patients with PCV. Baseline fundus photography, spectral-domain optical coherence tomography (SD-OCT), fluorescein and indocyanine green angiography (FA,ICGA) were assessed by trained medical graders. Typical PCV features were explored, and retinal and choroidal thickness (RT,CT) measurements were performed. Results: Seventy-nine eyes of 73 patients (mean age,72.6±11.9 years) were included. ICGA identified macular polyps in 89.9% of cases. SD-OCT revealed mostly subretinal fluid (93.6%) and a retinal pigment epithelium (RPE) detachment in 91.4%, with sharp protrusion in 67.0%. Polyp-like structures were seen in 74.3%, mostly adherent to an elevated RPE (69.6%). Type 1 neovascularization (NV) was identified in 74.7%, while 16.5% had a mixed NV. The mean macular CT was 220.9±83.2 µm (range,67.9-403.6). Diffuse and focal pachychoroid were observed in 26.6% and 30.4%. Soft drusen were reported in 62.0%, but retinal hemorrhage occurred in only 19.0%. Conclusion: The morphological features of PCV in Caucasians are similar to those reported in Asians. Pachychoroid signs were found in nearly half of our cohort. However, the mean age at presentation, high prevalence of soft drusen, and low prevalence of large subretinal hemorrhages make PCV closer to age-related macular degeneration in this ethnic group.

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Section: Discussionsupporting

confidence: 91%

Polypoidal Choroidal Vasculopathy in Caucasians: Morphological Findings from Multimodal Retinal Imaging

Simão¹,

Farinha²,

Marques³

et al. 2021

Ophthalmologica

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“…PCV associated with pachychoroid should therefore be differentiated from similar neovascularization associated to AMD [10,11,14] and it should be indicated as PPCV. Based on Gass classi cation, PCV is considered a type 1 subretinal neovascularization which grows underneath the RPE [15].…”

Section: Discussionmentioning

confidence: 99%

Polypoidal choroidal vasculopathy in pachychoroid: combined treatment with photodynamic therapy and aflibercept

et al. 2022

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Introduction To evaluate the effects of combined therapy using intravitreal A ibercept (IVA) and photodynamic therapy (PDT) on polypoidal choroidal vasculopathy related to pachychoroid disease (PPCV).Methods Patients with PPCV were treated with PDT combined with 3 IVA injections on a monthly basis, followed by pro re nata criteria. The 12-month follow-up consisted of multiple revaluations of visual acuity and SSOCT parameters of clinical activity.Results Nineteen eyes were included in the study; mean age was 65.5 years. Visual acuity improved after 12 months (0.35 ± 0.25 to 0.2 ± 0.20 logMAR, p = 0.005). Percentage of eyes with intraretinal and subretinal uid reduced from baseline to the 12-month follow-up (from 52.6-10.5%, p = 0.12, and from 89.5-5.3% p = 0.0009, respectively). Central retinal and mean macular thicknesses reduced (258 ± 39.6 to 204.8 ± 38.8 µm p = 0.04 and 293.8 ± 32.1 to 248.1 ± 29.6 µm p = 0.017 respectively). Central choroidal and mean choroidal thicknesses also displayed a reduction (328.6 ± 54.9 to 289.8 ± 44.6 µm p = 0.001 and 314.5 ± 55.3 to 287.9 ± 47.6 µm p = 0.015 respectively). The mean number of injections was 4.6/year. ConclusionThe results support the use of a combined therapy with A ibercept and PDT in PPCV. This treatment would act in synergy, with anti-VEGF controlling exudation and PDT closing the aneurysmal vessel and reducing choroidal congestion.

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“… 3 , 4 This might explain the rarity of combined PCV and RP, because PCV is considered to belong to the pachychoroid spectrum disorders of the macula. 5 Contrarily, decreased choroidal thickness has been reported in classic macular choroidal neovascularization (CNV), a change that might be considered more compatible with RP. There are two previous reports of RP cases that developed classic CNV, both of which responded well to intravitreal bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

Polypoidal choroidal vasculopathy in a case of retinitis pigmentosa, successfully treated with intravitreal aflibercept

Takahashi

Kunikata

Yasuda

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose Polypoidal choroidal vasculopathy (PCV) is a subtype of age-related macular degeneration that is seen frequently in Asians. Nevertheless, it is rare for this condition to be combined with retinitis pigmentosa (RP). The purpose of this paper is to present findings from this rare combination in a Japanese patient, and to describe its successful treatment with intravitreal aflibercept (IVA). Observations The patient was a 71-year-old Japanese woman with RP (diagnosed at the age of 30) and PCV. She noticed a decrease in vision in her right eye 6 months previously. Decimal best-corrected visual acuity (BCVA) was 0.05 in her right eye. Optical coherence tomography and indocyanine green angiography (IA) revealed serous retinal detachment (SRD) and PCV in her right eye. The SRD was initially resolved after 3 monthly treatments with IVA, but recurrences began 5 months later, requiring four more treatments with IVA, performed about every 4 months within the next 12 months, for successful resolution. There were no recurrences of PCV in 7 more months of follow-up, as confirmed with IA at the final appointment. Final decimal BCVA in the right eye improved to 0.15. Furthermore, macular retinal sensitivity, measured with microperimetry, increased after the treatment, and RP-related visual field narrowing, determined by Goldmann perimetry, did not progress throughout follow up of 26 months. Conclusion More than 2 years of follow up showed that IVA may be effective for treating PCV, even in RP patients, and can increase central visual function without causing progression of RP-related visual field narrowing.

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Morphological Difference of Choroidal Vasculature Between Polypoidal Choroidal Vasculopathy and Neovascular AMD on OCT: From the Perspective of Pachychoroid

Cited by 9 publications

References 36 publications

Polypoidal Choroidal Vasculopathy in Caucasians: Morphological Findings from Multimodal Retinal Imaging

Polypoidal Choroidal Vasculopathy in Caucasians: Morphological Findings from Multimodal Retinal Imaging

Polypoidal choroidal vasculopathy in pachychoroid: combined treatment with photodynamic therapy and aflibercept

Polypoidal choroidal vasculopathy in a case of retinitis pigmentosa, successfully treated with intravitreal aflibercept

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