Polypoidal Choroidal Vasculopathy

Koh, Adrian; Chen, Lee-Jen; Chen, Shih‐Jen; Chen, Youxin; Giridhar, Anantharam; Iida, Tomohiro; Kim, Hakyoung; Lai, Timothy Y. Y.; Lee, Won Ki; Li, Xiaoxin; Lim, Tock Han; Ruamviboonsuk, Paisan; Sharma, Tarun; Tang, Shibo; Yuzawa, Mitsuko

doi:10.1097/iae.0b013e3182852446

Cited by 234 publications

(150 citation statements)

References 167 publications

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“…The ICG angiogram is an important tool for studying the choroidal vasculature and is considered the gold standard test for PCV diagnosis [12,30]. It is likely that not performing systematic ICG angiograms in patients with neovascular AMD results in an underdiagnosis of PCV cases.…”

Section: Discussionmentioning

confidence: 99%

“…It is possible that a greater number of PCV cases would be diagnosed worldwide, if an ICG angiogram was performed at least in suspicious cases. Koh et al [12] emphasized that an ICG angiogram should be performed for the diagnosis of PCV when routine ophthalmoscopic examination indicates a serosanguineous maculopathy with one of the following features: (1) clinically visible orange-red subretinal nodules, (2) spontaneous massive subretinal hemorrhage, (3) notched or hemorrhagic PED and (4) a lack of response to anti-VEGF therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The polypoidal lesions and choroidal vascular network are well-documented by ICG angiography [12]. RAP is a subtype of neovascular AMD that is characterized by the early appearance of neovascularization, a contiguous telangiectasia in the retina, and variable onset (including late onset) of retinal-choroidal anastomosis [6].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

et al. 2015

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Purpose: To report features of neovascular age-related macular degeneration (AMD) in Brazilian patients. Procedures: Data were prospectively collected from patients diagnosed with neovascular AMD. Eyes were classified as having typical neovascular AMD, polypoidal choroidal vasculopathy (PCV), or retinal angiomatous proliferation (RAP). Results: In total, 265 eyes of 207 patients of predominantly Caucasian ancestry were included; 166 (62.6%) eyes had typical neovascular AMD, 65 (24.5%) eyes had PCV, and 34 (12.8%) eyes had RAP. RAP demonstrated a higher percentage of bilateral cases (p = 0.015). The mean foveal subfield thickness was significantly lower in eyes with PCV (p < 0.001). Cases with typical neovascular AMD had a higher percentage of predominantly classic and minimally classic lesions on fluorescein angiography (FA; p = 0.005). Conclusions: In Brazilian patients, PCV and RAP represented 24.5 and 12.8% of neovascular AMD cases. Neovascular AMD subtypes differ in relation to clinical features, mean foveal subfield thickness and FA presentation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

et al. 2015

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“…Therefore, an initial treatment plan for submacular hemorrhage with a presumable diagnosis of AMD might not be appropriate in Asian patients. In PCV patients, PDT with or without anti-VEGF has been reported to be more effective than anti-VEGF monotherapy in some studies [30,31,32,33]. Papavasileiou et al [26] reported favorable treatment outcomes when they differentially treated submacular hemorrhage based on underlying causes; after t-PA and C 3 F 8 gas injection, ranibizumab was administered in patients with typical AMD, and PDT was applied for PCV within 2 weeks of the initial injection [26].…”

Section: Discussionmentioning

confidence: 99%

Identification of Underlying Causes of Spontaneous Submacular Hemorrhage by Indocyanine Green Angiography

Kim

Lee²,

Kim

et al. 2015

Ophthalmologica

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Purpose: To investigate the causes of acute spontaneous submacular hemorrhage with indocyanine green angiography (ICGA). Methods: Retrospective observation case series. A total of 51 eyes from 51 patients with newly developed spontaneous submacular hemorrhage were enrolled. Best-corrected visual acuity (BCVA), fundus photography, fluorescein angiography, spectral domain optical coherence tomography (OCT), and ICGA at baseline were analyzed. The extent of hemorrhage using fundus photography, height of hemorrhage, and central foveal thickness measured by OCT was analyzed to compare the diagnostic and nondiagnostic groups. Results: The mean logarithm of the minimum angle of resolution (logMAR) BCVA at presentation was 1.21 ± 0.74 (Snellen equivalent, 20/324); the mean follow-up period was 23.9 ± 23.9 months. The cause of submacular hemorrhage was diagnosed in 43 of 51 eyes (84.3%) based on ICGA at presentation. The initial diagnoses were correct in 93% of eyes. In 3 cases, the initial diagnosis of age-related macular degeneration (AMD) was changed to polypoidal choroidal vasculopathy (PCV) based on follow-up ICGA. The central foveal thickness was significantly greater in the nondiagnostic group (1,102.4 vs. 666.7 μm, respectively; p = 0.008). The most common cause of submacular hemorrhage was neovascular AMD (52.9%), followed by PCV (37.3%), macroaneurysm (5.9%), and lacquer crack (3.9%). The mean final visual acuity was generally worse in patients with submacular hemorrhage with typical AMD (visual acuity 20/618) or PCV (visual acuity 20/240) compared to that in patients with retinal macroaneurysm (visual acuity 20/100) or lacquer crack (visual acuity 20/72). Conclusions: ICGA at initial presentation helps identify causes of submacular hemorrhage, allowing differential treatment approaches that may improve outcomes and safety.

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“…However, Song et al [141] reported that IVR without PDT for PCV in Korean patients resulted in significant visual and anatomical improvements over a 1-year follow-up period, and other reports suggested that the disappearance of the polypoidal lesions occurred at a high rate in PCV cases after anti-VEGF monotherapy [74,142,143]. A recent review suggested an overall improvement of the VA of PCV patients using IVR [144], and a most recent multicenter randomized controlled trial (LAPTOP study) revealed that IVR monotherapy achieved a significantly better visual prognosis than PDT monotherapy in PCV patients [145]. However, Matsumiya et al [16,17] reported that the degree of improvement in the VA in PCV patients was lower than that of tAMD patients treated by anti-VEGF monotherapy.…”

Section: Response To Treatmentmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy: Clinical Features and Genetic Predisposition

2013

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Polypoidal choroidal vasculopathy (PCV) is currently recognized as a phenotype of age-related macular degeneration (AMD). PCV is believed to be a type of choroidal neovascularization, although some cases of PCV show a distinct vascular abnormality of the choroidal vessels. PCV often shows several unique clinical manifestations which are apparently different from typical neovascular AMD (tAMD). In addition, the natural course and response to treatment are often different between tAMD and PCV. Moreover, recent genetic studies suggested a possible difference in the genetic susceptibility to disease between tAMD and PCV, as well as the existence of heterogeneity among PCV cases. In viewing the accumulation of knowledge about PCV, we have summarized the recent literature regarding PCV in this review article to improve the understanding of this clinical entity including possible susceptibility genes. We will also discuss the optimal treatment strategies for PCV in accordance with the results of recent clinical and genetic studies.

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Polypoidal Choroidal Vasculopathy

Abstract: Practical guidance on the clinical management of PCV is proposed based on expert evaluation of current evidence.

Cited by 234 publications

References 167 publications

Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

Identification of Underlying Causes of Spontaneous Submacular Hemorrhage by Indocyanine Green Angiography

Polypoidal Choroidal Vasculopathy: Clinical Features and Genetic Predisposition

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