Idiopathic polypoidal choroidal vasculopathy: a review of literature with clinical update on current management practice
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REVIEW
Idiopathic polypoidal choroidal vasculopathy: a review of literature with clinical update on current management practices Yamini Sahu . Niharika Chaudhary
. Mukesh Joshi . Aastha Gandhi
Received: 4 July 2020 / Accepted: 5 October 2020 Ó Springer Nature B.V. 2020
Abstract Purpose Polypoidal choroidal vasculopathy is a major cause of visual disability in a vast majority of Asian population due to exudative maculopathy. Although it is a distinctive disease entity with characteristic pathophysiology, genetics, immunology and clinical features, but it is still misdiagnosed as neovascular age related macular degeneration as both the diseases are a part of pachychoroid spectrum and have some similar features. Also, there are varied options for the management of this disease, but there are no clear recommendations. So, a detailed review of the literature has been done along with special attention to the recent therapeutic advances to help the readers get a better understanding of the disease and its current management practices. Method Detailed review of literature regarding polypoidal choroidal vasculopathy was done. The disease pathophysiology, genetics, risk factors,
Y. Sahu N. Chaudhary (&) A. Gandhi Department of Ophthalmology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Room No. 430 of Eye OPD, 4th Floor of OPD Building, Ansari Nagar, Ring Road, New Delhi 110 029, India e-mail: [email protected] M. Joshi Department of Ophthalmology, H.I.M.S.R and H.A.H. Centenary Hopsital, Nears GK.2, Alaknanda, New Delhi, India
diagnostic modalities along with current treatment guidelines were extensively studied and compiled. Result A comprehensive clinical update on polypoidal choroidal vasculopathy was compiled with special emphasis on the recent diagnostic modalities and treatment guidelines. Conclusion Polypoidal choroidal vasculopathy is a distinct clinical entity which can be diagnosed based on indocyanine green angiography and optical coherence tomography. Treatment includes various options like photodynamic therapy, anti VEGF agents and thermal laser ablation. A review of literature has been done and recent diagnostic modalities with management practices have been compiled for the better understanding of the disease. Keywords Polypoidal choroidal vasculopathy Polyps Indocyanine green angiography Photodynamic therapy Optical coherence tomography Anti VEGF agents
Introduction Polypoidal choroidal vasculopathy (PCV) is an abnormal choroidal vasculopathy characterized by terminal reddish-orange, spheroid aneurysmal polyp-like structures and dilated branching inner choroidal vessels (Branching vascular network, BVN) often associated
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with multiple recurrent serosanguineous pigment epithelial detachments (PEDs). It was first described by Yannuzzi et al. [1] in 1982 as a clinical entity occurring predominantly in the peripapillary area with multiple serosanguineous PEDs. PCV morphologically resembles wet neova
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