Polypoidal choroidal vasculopathy: Angiographic characterization of the network vascular elements and a new treatment paradigm

Costa, Rogério A.; Navajas, Eduardo V.; Farah, Michel Eid; Calucci, Daniela; Cardillo, J.A.; Scott, Ingrid U.

doi:10.1016/j.preteyeres.2005.01.001

Cited by 62 publications

(45 citation statements)

References 57 publications

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“…Polypoidal choroidal vasculopathy arises primarily due to abnormal choroidal circulation, resulting in characteristic lesions comprising well-defined vascular networks of vessels ending in polyp-like structures [3,4]. PCV lesions can be considered a subtype of AMD [3].…”

Section: Polypoidal Choroidal Vasculopathymentioning

confidence: 99%

Verteporfin PDT for non-standard indications—a review of current literature

Chan

Pece

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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Section: Polypoidal Choroidal Vasculopathymentioning

confidence: 99%

Verteporfin PDT for non-standard indications—a review of current literature

Chan

Pece

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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“…Several therapeutic procedures are used to treat PCV, including photodynamic therapy (PDT) and intravitreal injections of anti-vascular endothelial growth factor (VEGF). Patients with PCV generally respond well to PDT; [2][3][4][5][6][7][8][9][10][11] however, the vascular network often persists and causes recurrences, 10,12 which prevent good visual recovery. Therefore, reducing the number of recurrences is an important aspect of the treatment of PCV.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Oishi

Mandai

Kimakura

et al. 2011

Eye

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Objective To characterize an irregular capillary-like structure in the vascular network of eyes with polypoidal choroidal vasculopathy (PCV), and to determine whether its presence after photodynamic therapy (PDT) can be used to predict the clinical course of PCV. Methods We reviewed the clinical records of 29 eyes of 29 patients with PCV, who underwent PDT and confocal retinal angiographic examinations every 3 months. The images obtained before the PDT were compared with those after the PDT. The correlations between angiography findings and recurrences were evaluated. Results An area of fine, densely packed capillary-like vessels, named the fine vascular network, was identified within the polypoidal vascular network in 25 of 29 cases at the initial examination. The fine vascular network regressed in 23 cases (92%) after the first PDT. Thereafter, the fine vascular network remained or enlarged in 19 eyes, and 17 (84.5%) of these eyes had a recurrence of the polypoidal lesions or had exudative changes. In contrast, recurrences were found in only 2 of 10 (20%) eyes, whose fine network had regressed without a subsequent enlargement (Po0.001 compared with the former group). Conclusions A fine irregular vascular network is present in the majority of eyes with PCV before PDT. Its presence or expansion after PDT was significantly associated with a recurrence of PCV. Thus, we recommend that this network be monitored after treatment to determine whether a polypoidal vascular network will recur.

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“…In many cases, the vascular tree of the BVN is traceable to a single feeder vessel, possibly representing the vascular in-growth site crossing the Bruch's membrane. 40 If it is also associated with fluorescein leakage (as imaged by FFA) and overlying retinal thickening (as imaged by OCT, and observed clinically), these lesions look angiographically and behave clinically like CNV (CNV-like BVN). In a retrospective study of 52 consecutive cases of PCV, the authors found CNV-like BVN in one-third of cases (data presented at International Spectralis Meeting, Nice, 2008).…”

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Polypoidal choroidal vasculopathy: an angiographic discussion

Lim

Laude

Tan

2010

Eye

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The understanding of polypoidal choroidal vasculopathy has evolved rapidly in the past three decades. The hallmark of the disease is the presence of typical hyperfluorescent nodules in the early phase of indocyanine green angiography. Although the classical clinical presentation is recurrent serosanguinous detachment of the retinal pigment epithelium, it may present with clinical features indistinguishable from exudative age-related macular degeneration secondary to choroidal neovascularization. Some cases may present initially with submacular haemorrhage, but later with features of exudative age-related macular degeneration. Studying the associated network of vessels using confocal scanning laser ophthalmoscopy indocyanine green dynamic angiography revealed in many cases feeder vessels, branching pattern, and leakage similar to choroidal neovascularization. Owing to the overlap of clinical and angiographic features, it may be considered as a vascular subtype of exudative age-related macular degeneration. However, having seemingly better natural history, better response to photodynamic therapy, and incomplete response to antivascular endothelial growth factor therapy suggests that it should be studied as a separate entity from choroidal neovascularization. Combining angio-occlusion of the polyps using photodynamic therapy and antipermeability effect of anti-vascular endothelial growth factor therapy on the branching vascular network may provide a synergistic effect. We await the result of EVEREST trial, a multi-centre randomized controlled trial comparing photodynamic therapy, with or without ranibizumab, with ranibizumab monotherapy.

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Polypoidal choroidal vasculopathy: Angiographic characterization of the network vascular elements and a new treatment paradigm

Cited by 62 publications

References 57 publications

Verteporfin PDT for non-standard indications—a review of current literature

Verteporfin PDT for non-standard indications—a review of current literature

Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Polypoidal choroidal vasculopathy: an angiographic discussion

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