Pachychoroid disease: a new perspective on exudative maculopathy

Yanagi, Yasuo

doi:10.1007/s10384-020-00740-5

Cited by 73 publications

(77 citation statements)

References 96 publications

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“…The pathogenesis of CSC is considered to be a leakage from the pachychoroid through the retinal pigment epithelium (RPE). In PNV, pachychoroid-driven mechanisms induce choroidal neovascularization (CNV), which is characterized as type 1 CNV and polypoidal lesions [2,3]. Now, anti-vascular endothelial growth factor (VEGF) therapy is a gold standard for neovascular age-related macular degeneration (AMD).…”

Section: Introductionmentioning

confidence: 99%

Photodynamic therapy combined with anti-vascular endothelial growth factor therapy for pachychoroid neovasculopathy

et al. 2021

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This multicenter retrospective study was conducted to evaluate the 1-year treatment outcome of photodynamic therapy (PDT) combined with anti-vascular endothelial growth factor (VEGF) therapy for pachychoroid neovasculopathy (PNV). A total of 42 eyes of 42 patients with treatment-naïve PNV who were treated with PDT combined with intravitreal injections of an anti-VEGF agent (ranibizumab or aflibercept) for 1 year. All eyes showed exudative and/or hemorrhagic changes that affected the fovea at baseline. After the initial combination therapy, subfoveal choroidal thickness (SCT) and central retinal thickness (CRT) were significantly reduced and were maintained as such for 12 months (P < 0.01 in SCT and CRT). The best-corrected visual acuity (BCVA) (0.19 ± 0.30 at baseline) significantly improved at 3 months (0.15 ± 0.29, P < 0.05) and further improved at 12 months (0.10 ± 0.30, P < 0.01) when compared to that at baseline. After the initial combination therapy, 32 eyes (76.2%) required no additional treatments for 12 months. The mean number of additional PDT and intravitreal injections of anti-VEGF agents was 0.1 ± 0.3 and 0.9 ± 1.9, respectively. Of the 42 eyes included in this study, 22 eyes (52.4%) had polypoidal lesions at baseline. No significant differences in SCT, CRT, or BCVA were observed at any time points between eyes with and without polypoidal lesions. Of 20 eyes without polypoidal lesions, only 1 eye (5.0%) needed additional treatments. PNV, especially without polypoidal lesions, can be treated effectively with PDT combined with anti-VEGF therapy with few sessions.

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Section: Introductionmentioning

confidence: 99%

Photodynamic therapy combined with anti-vascular endothelial growth factor therapy for pachychoroid neovasculopathy

et al. 2021

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“…Because the definition of PNV is still evolving, PNV was classified based on the latest reports. 5,8,28 In our study, PNV characteristics included pachychoroid features, no soft drusen, and no polypoidal lesions (Figs. 1A-D).…”

Section: Classificationmentioning

confidence: 71%

Complement Activation Products and Cytokines in Pachychoroid Neovasculopathy and Neovascular Age-Related Macular Degeneration

Kato

Oguchi

Omori

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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To investigate the characteristics of complement activation products and angiogenic cytokines in the aqueous humor in eyes with pachychoroid neovasculopathy (PNV) and neovascular age-related macular degeneration (nAMD). METHODS. This was a prospective, comparative, observational study. All patients with choroidal neovascularization were classified as PNV without polyps, PNV with polyps (polypoidal choroidal vasculopathy [PCV]), or drusen-associated nAMD according to the presence or absence of pachychoroid features and soft drusen. This study included a total of 105 eyes. Aqueous humor samples were collected from 25 eyes with PNV without polyps, 23 eyes with PCV, and 24 eyes with drusen-associated nAMD before intravitreal anti-vascular endothelial growth factor (VEGF) injection and cataract surgery in 33 control eyes. Clinical samples were measured for complement component 3a (C3a), C4a, C5a, VEGF, and macrophage chemoattractant protein 1 (MCP-1) using a bead-based immunoassay. RESULTS. C3a and MCP-1 levels were significantly higher in PCV (P = 0.032 and P = 0.039, respectively) and drusen-associated nAMD (P = 0.01 for both comparisons) than in controls, and no difference was seen in C3a and MCP-1 levels between PNV and controls (P = 0.747 and P = 0.294, respectively). VEGF levels were significantly higher in PNV (P = 0.016), PCV (P = 0.009), and drusen-associated nAMD (P = 0.043) than in controls. In PNV, the VEGF levels elevated without elevated C3a and MCP-1. CONCLUSIONS. PNV, PCV, and drusen-associated nAMD had significantly distinct profiles of complement activation products and cytokines in the aqueous humor.

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“…Pachydrusen are found to be associated with thick subfoveal choroid by SS-OCT, further confirming that pachydrusen are a new entity distinct from soft drusen [1]. Subsequently the predictive role of pachydruen in disease progression has been established from nine publications from 2018 to 2020, confirming that pachydrusen are a precursor of PCV [24][25][26][27][28][29][30][31][32] and seven with CSC [27,30,[33][34][35][36]. Pachydrusen are included as member of PCD spectrum because they are associated with common PCD features including reduced choroidal vascular markings in fundus and small pigment epithelium detachments due to the drusenoid RPE changes.…”

Section: Discovery Of Various Extracellular Depositsmentioning

confidence: 78%