Polypoidal Choroidal Vasculopathy
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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 of the condition’s hallmark polypoidal dilatation and a branching network resulting in recurrent hemorrhages and serous leakage.
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.
PCV remains a clinical challenge. Classification and treatment of the condition continue 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.
KeywordsPolypoidal choroidal vasculopathy Branching vascular network Serosanguinous retinal pigment epithelium detachment Retinal detachment Vitreous hemorrhage
The editors thank Dr. Luiz Roisman for lending his expertise and reviewing this manuscript.
Compliance with Ethical Standards
Conflict of Interest
Raquel Goldhardt and Bradley Simon Rosen declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences Research EPID-006-15S, NIH Center Core Grant P30EY014801 and Research to Prevent Blindness Unrestricted Grant.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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