The natural history of polypoidal choroidal vasculopathy: a multi-center series of untreated Asian patients

Cheung, Chui Ming Gemmy; Yang, Elizabeth; Lee, Won Ki; Lee, Gary K. Y.; Mathur, Ranjana; Cheng, Jacob Y. C.; Wong, Doric; Wong, Tien Yin; Lai, Timothy Y. Y.

doi:10.1007/s00417-015-2933-2

Cited by 55 publications

(34 citation statements)

References 35 publications

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“…PRN anti-VEGF therapy, which is often administered in clinical practice, with or without PDT did not achieve a longterm improvement in VA, although the visual outcome was superior to that expected in patients with untreated disease. 16 Moreover, combination therapy could reduce the number of additional treatments in patients aged ≥70 years.…”

Section: Discussionmentioning

confidence: 99%

Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy

et al. 2018

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“…A total of 65 eyes from 65 consecutive patients with symptomatic, treatment-naive PCV were included in the study. The inclusion criteria were [1] treatment-naive PCV characterized by the presence of polyps with or without branching vascular network (BVN) in the posterior pole of ICGA [2], observed subretinal fluid (SRF) or intraretinal fluid (IRF) under examination of optical coherence tomography (OCT) or leakage on the examination of fluorescein angiography (FA) [3], and completed at least 6 months of monthly follow-up after the first treatment. Exclusion criteria included (1) patients who had eyes with wet age-related macular degeneration (AMD) (2); previously underwent vitrectomy, laser photocoagulation, intravitreal triamcinolone injection, any intravitreal anti-VEGF injection, or PDT (3); and presence of other eye diseases such as glaucoma, diabetic retinopathy, and retinal angiomatous proliferation (RAP), which may affect visual acuity (VA).…”

Section: Patientsmentioning

confidence: 99%

“…PCV is defined as polypoidal lesions with or without branching vascular networks during early-phase indocyanine green angiography (ICGA) which is more prevalent in Asians as compared with whites [1]. The natural course of PCV may repeat hemorrhage and leakage which lead to vision deteriorate significantly [2,3]. So the therapy for the treatment of PCV is necessary.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy of Three Loading Doses of Intravitreal Injection of Conbercept with Injection Combined with PDT for the Treatment of PCV

Zhao

2020

BioMed Research International

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Purpose. To compare the efficacy between initial 3-monthly intravitreal conbercept monotherapy and combination intravitreal conbercept with photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV). Methods. This is a retrospective, comparative study which involved 65 PCV eyes of 65 patients. According to the therapeutic regimen, the PCV patients were divided into two groups: 32 eyes with naive PCV received a PDT after the first intravitreal injection of conbercept (IVC) followed by pro re nata (prn) retreatment (combination group), and 33 eyes with naïve PCV received 3-monthly IVC monotherapy followed by prn regimen (IVC monotherapy group). All patients completed at least 6 months of monthly follow-up. Results. At month 6, best-corrected visual acuity (BCVA) improved significantly (P<0.05) in both groups compared with that at baseline; the mean changes of BCVA between the IVC monotherapy group and combination group have no significant difference (−0.22±0.22 vs. −0.17±0.22 LogMAR, P=0.38). The central retinal thickness (CRT) decreased significantly in the two groups (P<0.05), with no difference between the two groups (P=0.24). The complete regression rate of polyps was 58.6% (17 out of 29 eyes) in the IVC monotherapy group and 80.65% (25 out of 31 eyes) in the combination group, respectively (P=0.09, χ-squared test). The combination group required significantly fewer injections than the IVC monotherapy group (3.09±0.89 vs. 3.67±0.74, P=0.006). Conclusion. Conbercept monotherapy significantly improved visual acuity and effectively regressed polyps during 6-month follow-up time in the treatment of PCV.

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“…Unbehandelt zeigen PCV-Läsionen in 50 % der Fälle einen ungünstigen rezidivierenden Verlauf mit letztlich hämorrhagie-und narbenbedingtem permanentem Visusverlust. In der anderen Hälfte können sich die serosanguinösen Alterationen wie die Aktivität der Polypen spontan zurückbilden [117][118][119].…”

Section: Natürlicher Verlauf Der Pcvunclassified

Sonderformen choroidaler Neovaskularisationsmembranen

Sandner

2017

Klin Monatsbl Augenheilkd

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Choroidal neovascularisation (CNV) in the context of exsudative age-related macular degeneration (nAMD) can be divided into type 1 (occult) and type 2 (classical) membranes. Retinal angiomatous proliferation (RAP) or polypoidal choroidal vasculopathy (PCV) are "rare subtypes" of chorioretinal neovascularisation and are distinguished by their distinct morphology and the sometimes worse response to therapy. Chorioretinal anastomosis, severe exsudates with serosanguinous pigment epithelial detachment and, in PCV, orange-red lesions in the papillomacular bundle can be diagnostic. Indocyanine green angiography (ICGA) is considered the gold standard for diagnosis of PCV and delivers important information for RAP too. Typical characteristics of PCV include foci of hyperfluoresence, with pulsatile filling in the early phase. This characterises choroidal polypoidal lesions, often in connection with an abnormal choroidal vascular network. In RAP, typical retino-retinal anastomosis can be identified, in particular in areas with pigment epithelial detachment. Optical coherence tomography (OCT) can complement diagnostic testing. In cases of RAP, early therapy initiation with intravitreal anti-VEGF is crucial for the prognosis of visual acuity. PCV can exhibit spontaneous regression. In active disease, photodynamic therapy (PDT) is efficient in the closure of PCV polyps. In association with CNV, it makes sense to combine PDT and intravitreal anti-VEGF medication. In spite of the initial increase in visual acuity, this state is normally "only" stabilised in the long term. In patients with idiopathic secondary CNV membranes (high myopia, post-inflammatory, post-traumatic changes or in hereditary connective tissue diseases), small "classical" type 2 membranes are mostly involved. Hence, these are strictly speaking not directly rare subtypes. Nevertheless, these patients are mostly younger, with less protracted illness and limited available regeneration ability of the retinal pigment epithelium (RPE): they may therefore differ favourably from the courses with nAMD, with earlier inactivation and with fewer required anti-VEGF injections. CNV with angioid streaks are a special case in this group. Unfortunately, these lesions have a recurrent, protracted and, in the end, mostly frustrating course.

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The natural history of polypoidal choroidal vasculopathy: a multi-center series of untreated Asian patients

Cited by 55 publications

References 35 publications

Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy

Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy

Comparison of the Efficacy of Three Loading Doses of Intravitreal Injection of Conbercept with Injection Combined with PDT for the Treatment of PCV

Sonderformen choroidaler Neovaskularisationsmembranen

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