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Systematic Review and Meta-Analysis

Lorentzen, Thomas D., BSc*,†; Subhi, Yousif, MD*,†; Sørensen, Torben L., DMSc*,†

doi: 10.1097/IAE.0000000000001872
Original Study

Purpose: Polypoidal choroidal vasculopathy (PCV) is a disease with significant inter-ethnical differences. In this study, we systematically review the literature on the prevalence of PCV in whites referred with a diagnosis of exudative age-related macular degeneration (AMD).

Methods: We searched PubMed, Embase, the Cochrane Library, and the Web of Science on 24 March, 2017 for studies evaluating the prevalence of PCV in white patients with exudative AMD. Data extraction and risk of bias assessments were performed in duplicate. Studies were included for a qualitative review and a meta-analysis, including subgroup analysis for differences in age and sex.

Results: We included data from 11 studies (>2,200 participants). For diagnosis, indocyanine green angiography was used together with a set of supporting criteria on fundus examination and optical coherence tomography. Extramacular location was more prevalent in eyes with PCV. Drusen was present in the fellow eye in 17% to 27%. Pooled prevalence of PCV in white patients with exudative AMD was 8.7% (confidence interval 95%: 7.2%–10.3%). Patients with PCV were 3.7 years (confidence interval 95%: 2.1 years–5.3 years) younger than those with other exudative AMD. Sex did not differ significantly.

Conclusion: Polypoidal choroidal vasculopathy is not a rare subtype of exudative AMD in whites—it is present in approximately one in 11 patients.

The authors systematically reviewed the literature on the prevalence of polypoidal choroidal vasculopathy in whites with exudative age-related macular degeneration, and found a pooled prevalence estimate from the meta-analysis of 8.7%—one in 11 patients. Patients with polypoidal choroidal vasculopathy are 3.7 years younger than those with exudative age-related macular degeneration.

*Clinical Eye Research Division, Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark; and

Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Reprint requests: Yousif Subhi, MD, Clinical Eye Research Division, Department of Ophthalmology, Zealand University Hospital, Vestermarksvej 23, DK-4000 Roskilde, Denmark; e-mail:

Y. Subhi has previously received travel grants from Novartis and Bayer.

None of the authors has any conflicting interests to disclose.

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© 2018 by Ophthalmic Communications Society, Inc.