Abstract:Purpose: To demonstrate choroidal vascular changes and report a novel choroidal thickness contour in eyes with peripheral exudative hemorrhagic chorioretinopathy (PEHCR).Methods: Retrospective, observational, comparative case series. Fourteen eyes of nine patients with PEHCR and 14 eyes of 14 age-matched and sex-matched controls underwent swept-source optical coherence tomography. Choroidal thickness was measured from posterior edge of the retinal pigment epithelium-Bruch membrane to choroidoscleral interface … Show more
“…This can be explained by the rarity of the disease. We believe that is the largest case series of peripheral PCV cases as a subset of PEHCR, the others being 13 eyes reported by Shroff et al 12 and 10 eyes by Goldman et al. 5 Also, we did not look at the peripheral choroidal thickness in both groups in our study.…”
Section: Discussionmentioning
confidence: 78%
“…9,10 Choroidal thickness measured using wide-field OCT imaging in healthy eyes have shown peripheral choroidal thinning. 11 However, in eyes with PEHCR, the choroid in the periphery appeared thicker giving a club-shaped contour as described by Shroff et al 12…”
Purpose To compare clinical and imaging features and treatment outcomes between eyes having peripheral polypoidal choroidal vasculopathy (PCV) and macular PCV. Methods In this retrospective comparative case series, confirmed cases of peripheral and macular PCV cases on indocyanine green angiography (ICGA) were included. The various demographic features, imaging characteristics and clinical course between cases with peripheral and macular PCV were compared and analysed. Results Fifteen eyes of 12 patients and 22 eyes of 20 patients were diagnosed with peripheral PCV and macular PCV respectively based on polyps seen on ICGA. Mean age at presentation in peripheral and macular PCV groups were 76.3 ± 8.78 and 69.1 ± 8.64 years respectively (p = 0.038). Mean logMAR visual acuity in the peripheral and macular PCV group was 0.423 ± 0.568 and 0.535 ± 0.513 respectively (p = 0.595). Peripheral subretinal hemorrhage was noted commonly in the peripheral PCV group (n = 10, 66%) and hard exudates were common in the macular PCV (19, 86%) group. Subfoveal choroid was significantly thinner in peripheral PCV group compared to macular PCV group (215.2 ± 39.94 vs 283.3 ± 50.08; p = 0.001). At final follow-up visit, 50% eyes (n = 11) in macular PCV group were still active and 87% (n = 13) eyes in the peripheral PCV showed an inactive disease (p = 0.035). Conclusion Peripheral and macular PCV cases are two separate clinical entities having distinct pathogenesis, clinical and imaging features and treatment outcomes. Further studies are needed for understanding the pathomechanism in these distinct disease entities.
“…This can be explained by the rarity of the disease. We believe that is the largest case series of peripheral PCV cases as a subset of PEHCR, the others being 13 eyes reported by Shroff et al 12 and 10 eyes by Goldman et al. 5 Also, we did not look at the peripheral choroidal thickness in both groups in our study.…”
Section: Discussionmentioning
confidence: 78%
“…9,10 Choroidal thickness measured using wide-field OCT imaging in healthy eyes have shown peripheral choroidal thinning. 11 However, in eyes with PEHCR, the choroid in the periphery appeared thicker giving a club-shaped contour as described by Shroff et al 12…”
Purpose To compare clinical and imaging features and treatment outcomes between eyes having peripheral polypoidal choroidal vasculopathy (PCV) and macular PCV. Methods In this retrospective comparative case series, confirmed cases of peripheral and macular PCV cases on indocyanine green angiography (ICGA) were included. The various demographic features, imaging characteristics and clinical course between cases with peripheral and macular PCV were compared and analysed. Results Fifteen eyes of 12 patients and 22 eyes of 20 patients were diagnosed with peripheral PCV and macular PCV respectively based on polyps seen on ICGA. Mean age at presentation in peripheral and macular PCV groups were 76.3 ± 8.78 and 69.1 ± 8.64 years respectively (p = 0.038). Mean logMAR visual acuity in the peripheral and macular PCV group was 0.423 ± 0.568 and 0.535 ± 0.513 respectively (p = 0.595). Peripheral subretinal hemorrhage was noted commonly in the peripheral PCV group (n = 10, 66%) and hard exudates were common in the macular PCV (19, 86%) group. Subfoveal choroid was significantly thinner in peripheral PCV group compared to macular PCV group (215.2 ± 39.94 vs 283.3 ± 50.08; p = 0.001). At final follow-up visit, 50% eyes (n = 11) in macular PCV group were still active and 87% (n = 13) eyes in the peripheral PCV showed an inactive disease (p = 0.035). Conclusion Peripheral and macular PCV cases are two separate clinical entities having distinct pathogenesis, clinical and imaging features and treatment outcomes. Further studies are needed for understanding the pathomechanism in these distinct disease entities.
“…Yorihisa et al ( 81 ) documented that PEHCR has choroidal vascular alterations resembling PCV in the affected area on ICGA in a 74-year-old patient. In a retrospective, observational, comparative case series, the choroid was significantly thicker in temporal periphery in PEHCR eyes than that in control eyes (272.70 ± 80.20 μm vs. 166.60 ± 40.10 μm, p = 0.0002), the mean large choroidal vessel thickness is significantly thicker in PEHCR eyes in comparison with the control eyes (202.40 ± 50.80 μm vs.160.60 ± 40.50 μm, p = 0.0235), suggesting the favor inclusion of PEHCR in the pachychoriod disease spectrum ( 82 ). Larger cohort studies are warranted to further understand the pathophysiology of PEHCR and to investigate whether PEHCR is a new entity of PCD.…”
The choroid is the main source of blood and nourishment supply to the eye. The dysfunction of the choroid has been implicated in various retinal and choroidal diseases. The identification and in-depth understanding of pachychoroid spectrum disorders are based on the tremendous progress of optical coherence tomography (OCT) technology in recent years, although visibility of choroid is challenging in the era of the time or spectral domain OCT. The recent rapid revolution of OCTs, such as the enhanced depth imaging OCT and the swept-source OCT, has greatly contributed to the significant improvement in the analysis of the morphology and physiology of the choroid precisely, especially to the choroid–scleral boundary and vasculature. The present review highlights the recently available evidence on the measurement methodology and the clinical significance of choroidal thickness in retinal or choroidal disorders.
“… 20 Recently peripheral exudative hemorrhagic chorioretinopathy (PEHCR), which showed manifestations of peripheral PCV, was added to the spectrum of pachychoroid disease entities. 22 Figure 1 OCT images of PCV. …”
Polypoidal choroidal vasculopathy (PCV) is a vascular disease of the choroid that leads to hemorrhagic and exudative macular degeneration. It may cause significant vision loss and thus affect the quality-of-life and psychological well-being. Noninvasive, non-ICGA-based OCT criteria have shown reliable results to plan adjunct photodynamic therapy (PDT) treatment, with the complete and consistent coverage of polypoidal lesions (PL) and branching neovascular network (BNN). The safety and efficacy of anti-vascular endothelial growth factor (anti-VEGF) monotherapy and its combination with verteporfin PDT have been established. However, treatment is still challenging due to frequent follow-ups, non-availability of PDT, and need for multiple anti-VEGF injection visits that increase the treatment burden and lead to patients being lost to follow-up. Effective treatments that prolong intervals between injections while maintaining vision and anatomical gains remain a critical unmet need. Longer acting molecules, like brolucizumab, have shown non-inferiority in BCVA gains and superior anatomical outcomes compared to other anti-VEGF agents. Newer therapies in the pipeline to enhance the efficacy and longevity of treatment include Faricimab and a port delivery system (PDS). This review summarizes the most recent diagnostic and treatment approaches in PCV to offer better treatment avenues.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
