Raquel Goldhardt1,2, Bradley Simon Rosen3. 1. Miami Veterans Administration Medical Center, Miami, FL, USA. 2. Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, FL. 3. Marina del Rey, CA.
Abstract
PURPOSE OF REVIEW: The aim of this review is to summarize developments in the treatment of active polypoidal choroidal vasculopathy (PCV). PCV is associated with a poor visual prognosis as a consequence the condition's hallmark polypoidal dilatation and a branching network resulting in recurrent hemorrhages and serous leakage. RECENT FINDINGS: Recent research has provided new insights into the pathogenesis of PCV. While still considered a subtype of age-related macular degeneration, suggestions that PCV belongs to a spectrum of conditions that present with a pachychoroid are increasingly well accepted. Treatment remains challenging. Combination therapy (photodynamic therapy (PDT) and intravitreal anti-vascular endothelial growth factor (VEGF)) is associated with higher polyp closure rate, but polyp closure rate has not been correlated with superior visual outcomes. Current data points to non-inferiority of anti-VEGF alone versus combined with PDT when final vision acuity is the study outcome. SUMMARY: PCV remains a clinical challenge. Classification and treatment of the condition continues to evolve. Combination therapy may not be superior to anti-VEGF treatment alone in terms of visual acuity outcome, however data on long-term recurrence should be compared in formulating preferred treatment plans.
PURPOSE OF REVIEW: The aim of this review is to summarize developments in the treatment of active polypoidal choroidal vasculopathy (PCV). PCV is associated with a poor visual prognosis as a consequence the condition's hallmark polypoidal dilatation and a branching network resulting in recurrent hemorrhages and serous leakage. RECENT FINDINGS: Recent research has provided new insights into the pathogenesis of PCV. While still considered a subtype of age-related macular degeneration, suggestions that PCV belongs to a spectrum of conditions that present with a pachychoroid are increasingly well accepted. Treatment remains challenging. Combination therapy (photodynamic therapy (PDT) and intravitreal anti-vascular endothelial growth factor (VEGF)) is associated with higher polyp closure rate, but polyp closure rate has not been correlated with superior visual outcomes. Current data points to non-inferiority of anti-VEGF alone versus combined with PDT when final vision acuity is the study outcome. SUMMARY: PCV remains a clinical challenge. Classification and treatment of the condition continues to evolve. Combination therapy may not be superior to anti-VEGF treatment alone in terms of visual acuity outcome, however data on long-term recurrence should be compared in formulating preferred treatment plans.
Authors: Jian-Ping Tong; Wai-Man Chan; David T L Liu; Timothy Y Y Lai; Kwong-Wai Choy; Chi-Pui Pang; Dennis S C Lam Journal: Am J Ophthalmol Date: 2006-03 Impact factor: 5.258
Authors: Antonio P Ciardella; Irene M Donsoff; Sheau J Huang; Danielle L Costa; Lawrence A Yannuzzi Journal: Surv Ophthalmol Date: 2004 Jan-Feb Impact factor: 6.048
Authors: Yuichiro Ogura; Glenn J Jaffe; Chui Ming Gemmy Cheung; Gregg T Kokame; Tomohiro Iida; Kanji Takahashi; Won Ki Lee; Andrew A Chang; Jordi Monés; Divya D'Souza; Georges Weissgerber; Kinfemichael Gedif; Adrian Koh Journal: Br J Ophthalmol Date: 2021-07-22 Impact factor: 5.908