Skip Navigation LinksHome > April 2013 - Volume 33 - Issue 4 > POLYPOIDAL CHOROIDAL VASCULOPATHY: Evidence-Based Guidelines...
Retina:
doi: 10.1097/IAE.0b013e3182852446
Review

POLYPOIDAL CHOROIDAL VASCULOPATHY: Evidence-Based Guidelines for Clinical Diagnosis and Treatment

Koh, Adrian H.C. MD*; on behalf of the Expert PCV Panel; Chen, Lee-Jen MD; Chen, Shih-Jen MD; Chen, Youxin MD§; Giridhar, Anantharam MD; Iida, Tomohiro MD**,††; Kim, Hakyoung MD‡‡; Lai, Timothy Yuk Yau MD§§; Lee, Won Ki MD¶¶; Li, Xiaoxin MD, PhD***; Han Lim, Tock MMED(OPHTH), FRCS(EDIN)†††; Ruamviboonsuk, Paisan MD‡‡‡; Sharma, Tarun MD, FRCS ED, MBA§§§; Tang, Shibo MD¶¶¶; Yuzawa, Mitsuko MD****

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Abstract

Background: Polypoidal choroidal vasculopathy (PCV) is an exudative maculopathy affecting vision, with clinical features distinct from neovascular age-related macular degeneration. Currently, no evidence-based guidelines exist for its diagnosis and treatment.

Methods: A panel of experts analyzed a systematic literature search on PCV together with results of the EVEREST trial, the only published randomized controlled clinical trial in PCV. At a subsequent Roundtable meeting, recommendations for the management of PCV were agreed based on this analysis and their own expert opinion.

Results: Diagnosis of PCV should be based on early-phase nodular hyperfluorescence from choroidal vasculature visualized using indocyanine green angiography. Recommended initial treatment of juxtafoveal and subfoveal PCV is either indocyanine green angiography-guided verteporfin photodynamic therapy or verteporfin photodynamic therapy plus 3 × 0.5 mg ranibizumab intravitreal injections 1 month apart. If there is incomplete regression of polyps by indocyanine green angiography, eyes should be retreated with verteporfin photodynamic therapy monotherapy or verteporfin photodynamic therapy plus ranibizumab. If there is complete regression of polyps by indocyanine green angiography, but there is leakage on fluorescein angiography and other clinical or anatomical signs of disease activity, eyes should be retreated with ranibizumab.

Conclusion: Practical guidance on the clinical management of PCV is proposed based on expert evaluation of current evidence.

© The Ophthalmic Communications Society, Inc.

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