Idiopathic polypoidal choroidal vasculopathy: a review of literature with clinical update on current management practices

Int Ophthalmol. 2021 Feb;41(2):753-765. doi: 10.1007/s10792-020-01620-0. Epub 2020 Oct 20.

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, 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: Anti VEGF agents; Indocyanine green angiography; Optical coherence tomography; Photodynamic therapy; Polypoidal choroidal vasculopathy; Polyps.

Publication types

  • Review

MeSH terms

  • Choroid
  • Choroid Diseases* / drug therapy
  • Choroid Diseases* / therapy
  • Choroidal Neovascularization* / drug therapy
  • Choroidal Neovascularization* / therapy
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green
  • Photochemotherapy*
  • Polyps*
  • Retrospective Studies
  • Tomography, Optical Coherence

Substances

  • Indocyanine Green