Polypoidal Choroidal Vasculopathy in Asians

Abstract

Age related macular degeneration (AMD) in Asians has been suggested to differ from their Western counterparts in terms of epidemiology, pathogenesis, clinical presentation and treatment. In particular, polypoidal choroidal vasculopathy (PCV) appears to be the predominant subtype of exudative AMD in Asian populations, in contrast to choroidal neovascularization secondary to AMD (CNV-AMD) in Western populations. Epidemiological data on PCV has been largely limited to hospital-based studies and there are currently no data on the incidence of PCV. Similarities and differences in risk factor profile between PCV and CNV-AMD point to some shared pathogenic mechanisms but also differential underlying mechanisms leading to the development of each phenotype. Serum biomarkers such as CRP, homocysteine and matrix metalloproteinases suggest underlying inflammation, atherosclerosis and deranged extracellular matrix metabolism as possible pathogenic mechanisms. In addition, recent advances in genome sequencing have revealed differences in genetic determinants of each subtype. While the standard of care for CNV-AMD is anti-vascular endothelial growth factor (VEGF) therapy, photodynamic therapy (PDT) has been the mainstay of treatment for PCV, although long-term visual prognosis remains unsatisfactory. The optimal treatment for PCV requires further clarification, particularly with different types of anti-VEGF agents and possible benefits of reduced fluence PDT.

The impact of typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy on vision-related quality of life in Asian patients

“…There are few studies on Asian patients with late AMD, particularly neovascular AMD (nAMD), which presents differently in Asian compared with Western populations 6. For example, a major subtype of nAMD in Asian people is polypoidal choroidal vasculopathy (PCV),7 which affects up to 50% of Asians with nAMD and tends to present in younger patients sometimes acutely with massive subretinal haemorrhage and severe vision loss.…”

Etiologies and Characteristics of Choroidal Neovascularization in Young Chinese Patients

“…Patients with PCV usually present at a younger age than patients with neovascular AMD [23, 25, 26], and the youngest patient reported was 20 years old [27]. In addition, approximately 5.9–24.1% of Asian PCV patients have bilateral disease [25, 28]. In our study, the mean age of patients with PCV was 43.7 years.…”

Dual-stage deep learning framework for pigment epithelium detachment segmentation in polypoidal choroidal vasculopathy

“…Because our segmentation algorithm focuses on diseased images, we will build a classifier to separate normal and diseased images prior to segmentation in our future work. In addition, our database limited our algorithm testing on drusenoid PED, which seldom appears in PCV [47]. Since this type of PED did not show up in our PCV database, we will test the performance of our algorithm on it and other diseases in the future.…”