Pachychoroid neovasculopathy: a type-1 choroidal neovascularization belonging to the pachychoroid spectrum—pathogenesis, imaging and available treatment options

Sartini, Francesco; Figus, Michele; Casini, Giovanni; Nardi, Marco; Posarelli, Chiara

doi:10.1007/s10792-020-01522-1

Cited by 22 publications

(17 citation statements)

References 58 publications

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“…Patients with PCV with choroidal vascular hyperpermeability were associated with the G allele of age-related maculopathy susceptibility 2 (ARMS2) A69S and the T allele of complement factor H (CFH) , which are risk alleles for CSC 24 . Pachychoroid neovasculopathy is a type 1 neovascularization overlying focal areas of choroidal thickening and dilated choroidal vessels 25 . Shallow irregular RPE detachment on OCT images and absence of branching vascular network with aneurysmal lesions on ICGA images distinguish PNV from PCV (Fig.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of pachyvessels associated with polypoidal choroidal vasculopathy in chronic central serous chorioretinopathy

Wang

Chan

Tsai

et al. 2021

Sci Rep

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To investigate the association between clinical features of chronic central serous chorioretinopathy (CSC) and subsequent development of polypoidal choroidal vasculopathy (PCV). Characteristics and treatment response of PCV secondary to CSC were described. This retrospective observational study included 18 patients with chronic CSC (18 eyes) with subsequent PCV and 36 controls (36 eyes) with chronic CSC without PCV development during follow-up. Clinical features were compared between the two groups. A logistic regression model was used to evaluate the risk factor of PCV formation. Treatments for PCV included anti-vascular endothelial growth factor (VEGF) monotherapy, photodynamic therapy (PDT), or PDT and anti-VEGF combination treatment. Subretinal fluid on optical coherence tomography images were assessed after treatments. Significant between-group differences were observed in best-corrected visual acuity after disease resolution and presence of pachyvessels (P = .001 and P = .003, respectively). The presence of pachyvessels in chronic CSC was associated with subsequent PCV (odds ratio = 6.00; 95% CI, 1.74–20.68; P = .005). CSC recurrence and subfoveal choroidal thickness (SFCT) were not significantly associated with subsequent PCV development (P = .393 and P = .911, respectively). The mean age of PCV diagnosis was 51 years, and the mean time from CSC diagnosis to PCV confirmation was 77.8 months. The mean (range) SFCT of PCV was 327.7 (134–599) μm. Nine patients received anti-VEGF monotherapy and 5 had disease remission. Four patients received PDT and anti-VEGF combination treatment and all of the 4 had disease remission. In chronic CSC, pachyvessel characteristics are associated with subsequent PCV development. This result will assist clinicians to evaluate CSC in clinical practice and provide insights into the pathogenesis of PCV.

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Section: Discussionmentioning

confidence: 99%

Clinical features of pachyvessels associated with polypoidal choroidal vasculopathy in chronic central serous chorioretinopathy

Wang

Chan

Tsai

et al. 2021

Sci Rep

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“…Now, anti-vascular endothelial growth factor (VEGF) therapy is a gold standard for neovascular age-related macular degeneration (AMD). However, the efficacy of anti-VEGF therapy for PNV remains controversial [4,5]. On the other hand, in the clinical setting, photodynamic therapy (PDT) is rarely performed for the treatment of neovascular 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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“…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: 77%

Drusen and pachydrusen: the definition, pathogenesis, and clinical significance

Zhang

Sivaprasad

2020

Eye

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Pachychoroid neovasculopathy: a type-1 choroidal neovascularization belonging to the pachychoroid spectrum—pathogenesis, imaging and available treatment options

Cited by 22 publications

References 58 publications

Clinical features of pachyvessels associated with polypoidal choroidal vasculopathy in chronic central serous chorioretinopathy

Clinical features of pachyvessels associated with polypoidal choroidal vasculopathy in chronic central serous chorioretinopathy

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

Drusen and pachydrusen: the definition, pathogenesis, and clinical significance

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