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Review
. 2018 Sep 3;19(9):2611.
doi: 10.3390/ijms19092611.

The Use of Vascular Endothelial Growth Factor Inhibitors and Complementary Treatment Options in Polypoidal Choroidal Vasculopathy: A Subtype of Neovascular Age-Related Macular Degeneration

Kelvin Yi Chong Teo  1   2   3 , Mark Gillies  4 , Samantha Fraser-Bell  5
Affiliations
Review

The Use of Vascular Endothelial Growth Factor Inhibitors and Complementary Treatment Options in Polypoidal Choroidal Vasculopathy: A Subtype of Neovascular Age-Related Macular Degeneration

Kelvin Yi Chong Teo et al. Int J Mol Sci. .

Abstract

Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration (AMD; nAMD) which occurs more commonly in Asian populations as compared to Caucasians. PCV and nAMD share pathological mechanisms, including pathological expression of vascular endothelial growth factor (VEGF). The advent of anti-vascular endothelial growth factor (VEGF) revolutionized the treatment of nAMD. Despite being a subtype of nAMD, PCV responds less well to VEGF inhibitors; thus, photodynamic therapy (PDT) in combination with anti-VEGF treatment may be considered. This review aims to summarize the current evidence for the treatment of PCV, especially whether VEGF inhibitors should be used alone or in combination with PDT.

Keywords: AMD; PCV; anti-VEGF; photodynamic therapy; polypoidal choroidal vasculopathy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Fundus photographs showing the two clinical patterns of polypoidal choroidal vasculopathy (PCV): hemorrhagic (right) and serous (left).
Figure 2
Figure 2
Indocyanine green angiographic (ICGA) patterns of PCV: cluster of grapes configuration (dotted circle) with a hypofluorescent halo. Video angiography sometimes shows pulsatile lesions, which is a definitive sign for the diagnosis of PCV.
Figure 3
Figure 3
Spectral domain optical coherence tomography (OCT) features of PCV. The image on the top shows a sharp elevation of the retinal pigment epithelium (RPE) with underlying moderate reflectivity (asterisk) and double-layer sign, consisting of two hyper-reflective lines (white arrowheads). The bottom image shows the underlying thickened choroid (double-headed arrow).
See this image and copyright information in PMC

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