Polypoidal Choroidal Vasculopathy

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.

Efficacy and safety of brolucizumab versus aflibercept in eyes with polypoidal choroidal vasculopathy in Japanese participants of HAWK

“… 1 The condition is often associated with recurrent subretinal haemorrhages and fluid accumulation and, if left untreated, can lead to permanent vision loss. 1 2 Indocyanine green angiography (ICGA) remains the diagnostic method of choice for identifying the presence of aneurysmal dilations, the polypoidal lesions characteristic of PCV. 2 3…”

“…Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration (nAMD) characterised by polypoidal dilatation and a branching vascular network usually located above the Bruch’s membrane and below the retinal pigment epithelium (RPE). 1 The condition is often associated with recurrent subretinal haemorrhages and fluid accumulation and, if left untreated, can lead to permanent vision loss. 1 2 Indocyanine green angiography (ICGA) remains the diagnostic method of choice for identifying the presence of aneurysmal dilations, the polypoidal lesions characteristic of PCV.…”

Brolucizumab for the Treatment of Degenerative Macular Conditions: A Review of Clinical Studies

“…14 Unlike typical AMD, drusen are absent in PCV and recurrent subretinal haemorrhages and serous retinal detachments are the most common clinical findings. 12,13,15 PCV is an ocular condition with greater prevalence in Asian populations that is presumably influenced by both genetic and environmental factors. 16,17 Smoking, elevated C-reactive protein (CRP) levels, hypertension and history of central serous chorioretinopathy are some of the reported risk factors for PCV development.…”

“…Polypoidal choroidal vasculopathy (PCV) is considered a variant of nAMD characterised by polypoidal dilation with a branching neovascular network usually located between Bruch’s membrane and RPE. 12 , 13 The presence of polypoidal lesions is best detected using indocyanine green angiography (ICGA). 14 Unlike typical AMD, drusen are absent in PCV and recurrent subretinal haemorrhages and serous retinal detachments are the most common clinical findings.…”

“… 14 Unlike typical AMD, drusen are absent in PCV and recurrent subretinal haemorrhages and serous retinal detachments are the most common clinical findings. 12 , 13 , 15…”