Polypoidal choroidal vasculopathy and neovascularized age. Retina today polypoidal choroidal vasculopathy mayjune 2016. Listing a study does not mean it has been evaluated by the u. Polypoidal choroidal vasculopathy pcv is a disease primarily affecting the vascular layer of blood vessels in the choroid pronounced core oid, resulting in damage to the overlying retina where the photoreceptor cells responsible for vision reside see illustration. Ranibizumab for polypoidal choroidal vasculopathy pcv. The disease has been extensively described in asians and caucasians, but not in africans.
This study aims to describe the therapeutic responses to combination. Age related macular degeneration amd in asians has been suggested to differ from their western counterparts in terms of epidemiology, pathogenesis, clinical presentation and treatment. Currently, no evidencebased guidelines exist for its diagnosis and treatment. Introduction polypoidal choroidal vasculopathy pcv is a variant of neovascular age related macular degeneration. Treatment of polypoidal choroidal vasculopathy with. Intravitreal bevacizumab avastin with or without photodynamic therapy for the treatment of polypoidal choroidal vasculopathy. Pdf polypoidal choroidal vasculopathy nitin shetty. Polypoidal choroidal vasculopathy pcv is a visually debilitating disease that mostly affects people of african and asian heritage. Introduction polypoidal choroidal vasculopathy pcv was described for the first time in 19821. Although indocyaninegreen angiography icga is still the gold standard for diagnosis of pcv, the use of en face optical coherence tomography oct and oct angiography are useful tools in.
It is characterized by polypoidal dilatations at the terminus of branching vascular network located beneath the retinal pigment epithelium. Polypoidal choroidal vasculopathy pcv is a variant of agerelated macular degeneration amd and commonly manifests with type 1 choroidal neovascularization cnv. Efficacy and safety of ranibizumab with or without. It is present in both men and woman of many ethnicities, characterized by serosanguineous detachments of the pigmented epithelium and exudative changes that can commonly lead to subretinal fibrosis. Objective to determine the nature and frequency of polypoidal choroidal vasculopathy pcv in a series of patients suspected of having neovascularized agerelated macular degeneration amd. Polypoidal choroidal vasculopathy pcv is characterized by a branching vascular network bvn with terminal polypoidal dilations. Polypoidal choroidal vasculopathy the american society of. To determine if the firstchoice treatment, either pdt or intravitreal ranibizumab, has a longterm effect in patients with polypoidal choroidal vasculopathy. All patients underwent a complete ophthalmological examination including fundus photography, fluorescein angiography, indocyanine.
Polypoidal choroidal vasculopathy pcv is a subtype of neovascular agerelated macular degeneration namd, commonly seen in the asian population. These polypoidal lesions are best visualized on indocyanine green angiography. Treatment of polypoidal choroidal vasculopathy with transpupillary thermotherapy. Jun 09, 20 polypoidal choroidal vasculopathy pcv is a retinal disease involving the choroidal vasculature characterized by the presence of polypoidal lesions with or without branching vascular network best seen on indocyanine green angiography icga. Neovascular agerelated macular degeneration amd is a leading cause of blindness in the developed world. Longterm results of photodynamic therapy or ranibizumab for. It is dissimilar in epidemiology, genetic heterogeneity, pathogenesis, natural history, and response to treatment in comparison to namd. Indocyanine green angiography icga is the recommended exploratory method for definitive diagnosis. Pdf polypoidal choroidal vasculopathy as a disease is yet to be comprehended completely. We compared the characteristics of the polyps detected using bscan octa and icga.
New concepts in polypoidal choroidal vasculopathy imaging. Then, the diagnostic concordance of each polypoidal lesion between icga and octa was evaluated. Polypoidal choroidal vasculopathy polypoidal choroidal vasculopathy pcv is a disease primarily affecting the vascular layer of blood vessels in the choroid pronounced core oid, resulting in damage to the overlying retina where the photoreceptor cells responsible for vision reside see illustration. More than a quarter century has passed since the original description of polypoidal choroidal vasculopathy pcv in 1982 as a peculiar hemorrhagic. To determine if the firstchoice treatment, either pdt or intravitreal ranibizumab, has a longterm effect in patients with polypoidal choroidal vasculopathy pcv. Optical coherence tomography angiography characteristics of. A retinal masquerader a patient presents with what appears to be macular sensory detachment. The clinical features consisting of huge serosanguineous retinal pigment epithelial and neurosensory layer detachments, although unique may closely mimick neovascular agerelated macular degeneration and other counterparts. To report the clinical features and outcomes of polypoidal choroidal vasculopathy pcv in chinese patients with or without laser treatment. Polypoidal choroidal vasculopathy is presumed to be a variant of occult cnv. A closer look reveals an additional unique finding.
To our knowledge, there are no large randomized clinical trials to evaluate intravitreal ranibizumab, with and without verteporfin photodynamic therapy vpdt, for the treatment of pcv. Effect of intravitreal vegftrap eye on polypoidal choroidal vasculopathy vault the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Polypoidal choroidal vasculopathy pcv is an exudative maculopathy affecting vision, with clinical features distinct from neovascular agerelated macular degeneration. Polypoidal choroidal vasculopathy pcv is an agerelated macular degeneration amd subtype and is seen particularly in asians. Polypoidal choroidal vasculopathy in highly myopic eyes. Polypoidal choroidal vasculopathy pcv is a disease characterized by abnormal branching vascular channels with terminal dilatations. Recent research has provided new insights into the pathogenesis of pcv. Polypoidal choroidal vasculopathy examined with en face. Methods a prospective analysis of 167 consecutive, newly diagnosed patients aged 55 years or older. Polypoidal choroidal vasculopathy pcv is a disease of the choroidal vasculature.
They reported that this entity was noticed in white patients too, although it was more common among pigmentary races. Most reports previously have been uncertain as to whether pcv represents a choroidal vascular abnormality or a type of subretinal neovascularization. Polypoidal choroidal vasculopathy pcv is a relatively new clinical entity characterized by multiple recurrent serous or hemorrhagic detachments of the retinal pigment epithelium rpe and retina in the posterior pole of the eye. Polypoidal choroidal vasculopathy the american society. Typically presents in 7th to 8th decade of life, though may present earlier th. Polypoidal choroidal vasculopathy pcv is a disease primarily affecting the vascular layer of blood vessels in the choroid pronounced core.
In particular, polypoidal choroidal vasculopathy pcv appears to be the predominant subtype of exudative amd in asian populations, in contrast to choroidal neovascularization secondary to amd cnvamd in. Clinical characteristics of polypoidal choroidal vasculopathy. Ranibizumab for polypoidal choroidal vasculopathy pcv pearl the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. New paradigms in polypoidal choroidal vasculopathy management. Optical coherence tomography angiography characteristics. Characteristics of polypoidal choroidal vasculopathy evaluated by optical coherence tomography angiography taneto tomiyasu, miho nozaki, munenori yoshida, and yuichiro ogura department of ophthalmology and visual science, nagoya city university graduate school of medical sciences, nagoya, japan correspondence. In particular, polypoidal choroidal vasculopathy pcv, a vascular disease of the choroid, appears to be the predominant subtype of exudative or wet amd in asian populations, in contrast to choroidal neovascularization secondary to amd cnvamd in western populations 4. Methods all patients with ipcv attending the macular clinic underwent a complete ocular examination, and. Polypoidal choroidal vasculopathy pcv is increasingly recognized as an important cause of exudative maculopathy in asians as against wet. Importance polypoidal choroidal vasculopathy pcv is a common subtype of exudative agerelated macular degeneration among asian individuals. Classic choroidal neovascularization, photocoagulation, polypoidal choroidal vasculopathy, serosanguineous detachment, visual outcome. A study of laser photocoagulation for polypoidal choroidal. Idiopathic polypoidal choroidal vasculopathy nature. Genetic associations in polypoidal choroidal vasculopathy.
Current management of polypoidal choroidal vasculopathy. Polypoidal choroidal vasculopathy is considered a variant form of cnv characterized by the presence of multiple vascular sacular dilations polyps in the choroidal circulation that manifests clinically with variably sized serous and serosanguineous detachments of the neurosensory retina and rpe, usually. Jan 10, 2018 polypoidal choroidal vasculopathy pcv is a variant of agerelated macular degeneration amd and commonly manifests with type 1 choroidal neovascularization cnv. We had a recent case of polypoidal choroidal vasculopathy here at the moran eye center, imaged here as an icg angiogram large image here polypoidal choroidal vasculopathy is an uncommon disorder of the choroidal circulation summarized in the ciardella et. Polypoidal choroidal vasculopathy is a relatively common type of degenerative macular disease among the chinese population. Backgroundaim we previously reported that ranibizumab performed better on visual prognosis than photodynamic therapy pdt in a ranibizumab lucentis and photodynamic therapy on polypoidal choroidal vasculopathy laptop study. Polypoidal choroidal vasculopathy pcv was initially described by yannuzzi as a cause of exudation and bleeding in the macula 12. Nov 16, 2016 polypoidal choroidal vasculopathy is a relatively common type of degenerative macular disease among the chinese population.
To study the morphologic features of polypoidal choroidal vasculopathy pcv with the use of en face optical coherence tomography oct. Is polypoidal choroidal vasculopathy pcv a subtype of neovascular age related macular degeneration amd or a separate clinical entity. Longterm results of photodynamic therapy or ranibizumab. Purpose to analyse the morphological characteristics of polypoidal choroidal vasculopathy pcv on optical coherence tomography angiography octa. Efficacy of intravitreal bevacizumab for polypoidal choroidal vasculopathy. Abnormal vasculature in patients with poly poidal choroidal vasculopathy pcv consists of a branching vascular network bvn with polypoidal lesions at the. Sep 22, 2015 polypoidal choroidal vasculopathy pcv is a disease characterized by abnormal branching vascular channels with terminal dilatations. The macular region was examined with oct en face planes scanned at different sequential depths, following which detailed scanning was performed of arbitrarily. Methods a prospective analysis of 167 consecutive, newly diagnosed patients aged 55. In particular, polypoidal choroidal vasculopathy pcv, a vascular disease of the choroid, appears to be the predominant subtype of exudative or wet amd in asian populations, in contrast to choroidal neovascularization secondary to amd cnvamd in. Polypoidal choroidal vasculopathy pcv is a variant of neovascular agerelated macular degeneration. Idiopathic polypoidal choroidal vasculopathy associated with retinal arterial macroaneurysm and hypertensive retinopathy.
Polypoidal choroidal vasculopathy pcv asia pacific. Polypoidal choroidal vasculopathy pcv is characterised by multiple recurrent serosanguineous bilateral retinal pigment epithelial detachments. Polypoidal choroidal vasculopathy pcv primarily affects pigmented individuals, especially asians and africanamericans. Polypoidal choroidal vasculopathy pcv was first described by yannuzzi et al. Polypoidal choroidal vasculopathy pcv is an exudative maculopathy affecting vision, with clinical features distinct from. Polypoidal choroidal vasculopathy pcv is a retinal disease involving the choroidal vasculature characterized by the presence of polypoidal lesions with or without branching vascular network best seen on indocyanine green angiography icga. Presented at the macula society meeting, miami, florida and published in 1990 to describe a choroidal vasculopathy leading to serous and haemorrhagic pigment epithelial detachments. Jcm free fulltext polypoidal choroidal vasculopathy in. Polypoidal choroidal vasculopathy complicating retinal. Intravitreal bevacizumab avastin with or without photodynamic therapy for. New paradigms in polypoidal choroidal vasculopathy.
Polypoidal choroidal vasculopathy a type i polypoidal. Polypoidal choroidal vasculopathy pcv is a retinal disorder commonly found in asians presenting as neovascular agerelated macular degeneration and is characterized by serous macular detachment. Treatment of polypoidal choroidal vasculopathy retina today. Recently, freund has proposed that pcv is a form of type i subretinal. Pdf polypoidal choroidal vasculopathy in chinese patients. Jcm free fulltext polypoidal choroidal vasculopathy. Pcv is associated with a poor visual prognosis as a consequence of the conditions hallmark polypoidal dilatation and a branching network resulting in recurrent hemorrhages and serous leakage. Among 54 eyes of 52 patients, all 54 eyes showed flow signals. This study was conducted to document the clinical presentation. Polypoidal choroidal vasculopathy american society of retina.