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Polypoidal Choroidal Vasculopathy

  • Retina (R Goldhardt, Section Editor)
  • Published:
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Abstract

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 Findings

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.

Summary

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.

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Acknowledgements

The editors thank Dr. Luiz Roisman for lending his expertise and reviewing this manuscript.

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Authors and Affiliations

  1. Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, USA

    Raquel Goldhardt

  2. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA

    Raquel Goldhardt

  3. Marina del Rey, USA

    Bradley Simon Rosen

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Correspondence to Raquel Goldhardt.

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Raquel Goldhardt and Bradley Simon Rosen declare that they have no conflict of interest.

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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.

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Goldhardt, R., Rosen, B.S. Polypoidal Choroidal Vasculopathy. Curr Ophthalmol Rep 7, 66–72 (2019). https://doi.org/10.1007/s40135-019-00201-4

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