New Concepts for the Diagnosis of Polypoidal Choroidal Vasculopathy

Abstract

Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration (nAMD) that is characterized by a branching neovascular network and polypoidal lesions. It is important to differentiate PCV from typical nAMD as there are differences in treatment response between subtypes. Indocyanine green angiography (ICGA) is the gold standard for diagnosing PCV; however, ICGA is an invasive detection method and impractical for extensive use for regular long-term monitoring. In addition, access to ICGA may be limited in some settings. The purpose of this review is to summarize the utilization of multimodal imaging modalities (color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), and fundus autofluorescence (FAF)) in differentiating PCV from typical nAMD and predicting disease activity and prognosis. In particular, OCT shows tremendous potential in diagnosing PCV. Characteristics such as subretinal pigment epithelium (RPE) ring-like lesion, en face OCT-complex RPE elevation, and sharp-peaked pigment epithelial detachment provide high sensitivity and specificity for differentiating PCV from nAMD. With the use of more practical, non-ICGA imaging modalities, the diagnosis of PCV can be more easily made and treatment tailored as necessary for optimal outcomes.

Intraocular lens power calculation for silicone oil-dependent eyes

“…The SO-dependent group (Group A) included 13 patients (7 male and 6 female patients), and SO cannot be removed because of poor retinal or poor general conditions, or both. Specifically, four patients were diagnosed with polypoidal choroidal vasculopathy (PCV), which characteristically presents as a sub-retinal pigment epithelium (RPE) lesion ( 15 ). RPE destruction was also observed in patients with PCV, leading to suboptimal attachment of the neurosensory epithelium and RPE ( 16 ).…”

Recent Advances in Imaging Polypoidal Choroidal Vasculopathy with Swept-Source Optical Coherence Tomography Angiography

“…PCV can cause multiple, recurrent serosanguineous detachments of the retinal pigmented epithelial (RPE) and neurosensory retina and secondary bleeding or leakage [2]. Currently, the gold standard for PCV diagnosis is indocyanine green angiography (ICGA), which shows bright, hyperfluorescent polypoidal lesions (PLs) that are usually accompanied by branching vascular networks (BVNs) [3]. However, this method is invasive and carries rare but deadly complications.…”