Polypoidal choroidal vasculopathy: a comprehensive clinical update

Kumar, Atul; Kumawat, Devesh; M, Dheepak Sundar; Gagrani, Meghal; Gupta, Bindiya; Roop, Prakhyat; Hasan, Nasiq; Sharma, Anu; Chawla, Rohan

doi:10.1177/2515841419831152

Cited by 27 publications

(43 citation statements)

References 161 publications

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“…A study based on biomicroscopy of PCV supported the similar mechanism of compression effect from a sclerosed vessel in branch retinal vein occlusion (BRVO), causing vascular fragility, degeneration, polypoidal formation, vascular leakage, and hemorrhage [9]. In addition, the presence of polyps in the early phase and leakage in the late phase in an ICGA further enhanced this theory [4,9].…”

Section: Discussionmentioning

confidence: 88%

“…The prevalence of ODD is very low and their association with CNV and PCV is extremely rare, with no established treatment regimen [4]. The management of PCV varies according to the clinical-pathological manifestations of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…PCV is an inner choroidal abnormality characterized by polypoid dilatations of choroidal vessels with branching vascular networks. It is known as a subtype of neovascular age-related macular degeneration because it resembles similar morphological features [4]. To best of our knowledge, PCV associated with ODD has not been reported.…”

Section: Introductionmentioning

confidence: 92%

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A Case of Polypoidal Choroidal Vasculopathy Associated With Optic Disc Drusen

Sarojini

Ling

Teh

et al. 2020

Cureus

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We report a case of optic disc drusen (ODD) associated with peripapillary polypoidal choroidal vasculopathy (PCV). A 62-year-old Malay lady presented with both eye ODD and the left eye associated with peripapillary subretinal hemorrhage. Ultrasound B-scan and red-free photography confirmed the optic nerve head drusen findings bilaterally. Optical coherence tomography (OCT) of the left eye showed sharply elevated peripapillary pigment epithelial detachment with subretinal fluid. The presence of peripapillary polyps with branching vascular network in indocyanine green angiography of the left eye further confirmed the diagnosis of PCV and excluded choroidal neovascularization (CNV) secondary to ODD. Subsequently, the patient was treated with a combination of verteporfin photodynamic therapy with three monthly intravitreal ranibizumab injections. Three months after the combined treatment, OCT showed completely resolved subretinal fluid. ODD can cause compression of the subretinal vessels at the optic disc that results in retinal ischemia and release of vascular endothelial growth factor, which may trigger the development of CNV or PCV. The rarity of this combination makes it interesting to study more cases of ODD with PCV. Importantly, a thorough evaluation in distinguishing the PCV from the CNV that mimics it is crucial for early detection and prompt intervention. In this case, indocyanine green angiography (ICGA) is the diagnostic method to differentiate the PCV from CNV secondary to ODD.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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A Case of Polypoidal Choroidal Vasculopathy Associated With Optic Disc Drusen

Sarojini

Ling

Teh

et al. 2020

Cureus

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“…Various systemic risk factors have been associated with PCV to varying degrees [1,9,41]. Among them, systemic arterial hypertension (HTN) has been singled out in some reports with proportions of patients with HTN ranging between 20% and 70% [30,[36][37][38][39][42][43][44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy in Congolese Patients

Kabedi

Kayembe

Elongo

et al. 2020

Journal of Ophthalmology

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Purpose. Polypoidal choroidal vasculopathy (PCV) is a visually debilitating disease that mostly affects people of African and Asian heritage. Indocyanine green angiography (ICGA) is the recommended exploratory method for definitive diagnosis. The disease has been extensively described in Asians and Caucasians, but not in Africans. This study was conducted to document the clinical presentation and optical coherence tomography features of polypoidal choroidal vasculopathy (PCV) in Congolese patients. Methods. A prospective case series of patients with PCV was performed between January 2017 and June 2019. Routine ocular examination was performed including best corrected visual acuity measurement, slit-lamp examination, dilated direct fundoscopy, and spectral domain optical coherence tomography (OCT). The diagnosis was based on a combination of clinical and OCT signs. Results. Fourteen patients were diagnosed with PCV during this period. The average age was 64.7 ± 6.9 years. There were 8 females. Ten (71.4%) patients had systemic hypertension. Most patients (n = 9, 64.3%) had bilateral involvement. Blurred vision was the most common complaint (71.4%). The main clinical presentation was subretinal exudates, seen in 19 (82.6%) eyes of 11 (78.6%) patients and subretinal hemorrhage in 10 (43.5%) eyes. Macular localization was found in 16 eyes (69.5%) of 12 (85.7%) patients. Drusen were observed in 35.7% of the patients. On OCT imaging, thumb-like pigment epithelial detachment and subretinal exudation were the most frequent features, observed in 92.9% and 71.4% of the patients, respectively. Conclusions. PCV in Congolese patients showed features that are more similar to those observed in Caucasians. In this setting where indocyanine green angiography is not available, OCT facilitates the diagnosis of PCV.

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“…Polypoidal choroidal vasculopathy (PCV) is a distinct clinical entity characterized by polypoidal abnormalities of vessels originating from the choroid, also described as aneurismal type 1 neovascularization in the literature [ 1 , 2 ]. It is an important differential diagnosis to neovascular age-related macular degeneration (AMD) since the accepted standard treatment of neovascular AMD is monotherapy using intravitreal injections of vascular endothelial growth factor inhibitors (anti-VEGF), whereas the accepted standard treatment of PCV is based on a combination therapy using and full-dose photodynamic therapy to achieve polyp closure and anti-VEGF [ 1 , 3 , 4 ]. In some cases, monotherapy with either photodynamic therapy or anti-VEGF may suffice for PCV.…”

Section: Introductionmentioning

confidence: 99%

Plasma Levels of Matrix Metalloprotease MMP-9 and Tissue Inhibitor TIMP-1 in Caucasian Patients with Polypoidal Choroidal Vasculopathy

Sørensen

Subhi

Molbech

et al. 2020

Vision

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Background: Matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinases 1 (TIMP-1) are regulating enzymes of the extracellular matrix. A systemic imbalance of MMP-9 and TIMP-1, thought to reflect an imbalance of the extracellular matrix homeostasis, is previously associated with polypoidal choroidal vasculopathy (PCV) in Asian patients. Previous studies suggest inter-ethnical differences in the genetic background and etiology of PCV. To further explore this issue, we studied the plasma levels of MMP-9 and TIMP-1 in Caucasian patients with PCV and compared to healthy age-matched controls. Methods: For this prospective case-control study, 60 participants were recruited who were either patients with PCV (n = 26) or healthy controls (n = 34). All participants underwent detailed clinical examination. We sampled fresh venous blood, isolated plasma, and quantified plasma concentrations of the extracellular matrix regulators MMP-9 and TIMP-1 using electrochemiluminescence immunoassays. Results: Plasma levels of MMP-9 (p = 0.4), TIMP-1 (p = 0.9), and MMP-9/TIMP-1 ratio (p = 0.4) did not differ significantly between patients with PCV and healthy controls. No differences appeared after adjusting for influencing co-variates in multivariate analyses. Conclusion: We demonstrate that Caucasian patients with PCV do not have altered levels of plasma MMP-9 or plasma TIMP-1. These findings suggest no strong evidence of a systemic imbalance of the extracellular matrix homeostasis in Caucasian patients with PCV. Our findings are in line with studies of other aspects of PCV that are also subject to significant inter-ethnical differences.

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Polypoidal choroidal vasculopathy: a comprehensive clinical update

Cited by 27 publications

References 161 publications

A Case of Polypoidal Choroidal Vasculopathy Associated With Optic Disc Drusen

A Case of Polypoidal Choroidal Vasculopathy Associated With Optic Disc Drusen

Polypoidal Choroidal Vasculopathy in Congolese Patients

Plasma Levels of Matrix Metalloprotease MMP-9 and Tissue Inhibitor TIMP-1 in Caucasian Patients with Polypoidal Choroidal Vasculopathy

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