Consensus and guidelines on diagnosis and management of polypoidal choroidal vasculopathy (PCV) from the Asia-Pacific Vitreo-retina Society (APVRS)

Paisan Ruamviboonsuk¹, Danny S C Ng², Voraporn Chaikitmongkol³, Andrew Chang⁴, Shih-Jen Chen⁵, Youxin Chen⁶, Chui Ming Gemmy Cheung⁷, Fumi Gomi⁸, Robyn Guymer⁹, Judy E Kim¹⁰, Adrian Koh¹¹, Gregg T Kokame¹², Chi-Chun Lai¹³, Timothy Y Y Lai¹⁴, Won Ki Lee¹⁵, Yuichiro Ogura¹⁶, Srinivas Sadda¹⁷, Kelvin Y C Teo¹⁸, Tien Yin Wong¹⁹, Yasuo Yanagi²⁰, Dennis S C Lam²¹

Affiliations

¹ Department of Ophthalmology, College of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand. Electronic address: paisan.trs@gmail.com.
² The C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong.
³ Department of Ophthalmology, Retina Division, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁴ Sydney Retina Clinic, Sydney Eye Hospital, University of Sydney, Sydney, NSW, Australia.
⁵ Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
⁷ Singapore National Eye Centre, Singapore, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore.
⁸ Department of Ophthalmology, Hyogo Medical University, Hyogo, Japan.
⁹ Centre for Eye Research Australia, University of Melbourne, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
¹⁰ Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹¹ Eye & Retina Surgeons, Camden Medical Centre, Singapore, Singapore.
¹² Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, HI, USA.
¹³ Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
¹⁴ Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
¹⁵ Nune Eye Hospital, Seoul, Republic of Korea.
¹⁶ Department of Ophthalmology and Visual Science, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
¹⁷ Doheny Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
¹⁸ Singapore National Eye Centre, Singapore, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore.
¹⁹ Singapore Eye Research Institute, Singapore, Singapore; Beijing Visual Science and Translational Eye Research Institute, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
²⁰ Department of Ophthalmology and Microtechnology, Yokohama City University, Yokohama, Japan.
²¹ The Primasia International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China. Electronic address: dlam.pub.pieri.cuhk.sz@gmail.com.

PMID: 39824255
DOI: 10.1016/j.apjo.2025.100144

Free article

Consensus and guidelines on diagnosis and management of polypoidal choroidal vasculopathy (PCV) from the Asia-Pacific Vitreo-retina Society (APVRS)

Paisan Ruamviboonsuk et al. Asia Pac J Ophthalmol (Phila). 2025 Jan-Feb.

Free article

. 2025 Jan-Feb;14(1):100144.

doi: 10.1016/j.apjo.2025.100144. Epub 2025 Jan 15.

Authors

Affiliations

¹ Department of Ophthalmology, College of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand. Electronic address: paisan.trs@gmail.com.
² The C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong.
³ Department of Ophthalmology, Retina Division, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁴ Sydney Retina Clinic, Sydney Eye Hospital, University of Sydney, Sydney, NSW, Australia.
⁵ Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
⁷ Singapore National Eye Centre, Singapore, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore.
⁸ Department of Ophthalmology, Hyogo Medical University, Hyogo, Japan.
⁹ Centre for Eye Research Australia, University of Melbourne, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
¹⁰ Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹¹ Eye & Retina Surgeons, Camden Medical Centre, Singapore, Singapore.
¹² Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, HI, USA.
¹³ Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
¹⁴ Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
¹⁵ Nune Eye Hospital, Seoul, Republic of Korea.
¹⁶ Department of Ophthalmology and Visual Science, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
¹⁷ Doheny Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
¹⁸ Singapore National Eye Centre, Singapore, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore.
¹⁹ Singapore Eye Research Institute, Singapore, Singapore; Beijing Visual Science and Translational Eye Research Institute, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
²⁰ Department of Ophthalmology and Microtechnology, Yokohama City University, Yokohama, Japan.
²¹ The Primasia International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China. Electronic address: dlam.pub.pieri.cuhk.sz@gmail.com.

PMID: 39824255
DOI: 10.1016/j.apjo.2025.100144

Abstract

A panel of 21 international experts are formed by the Asia-Pacific Vitreo-retina Society to work out the consensus and guidelines on polypoidal choroidal vasculopathy (PCV). PCV is a common subtype of neovascular age-related macular degeneration and is more prevalent in Asian populations. Recent advancement in imaging technology allows greater understanding of the disease process of PCV. Furthermore, non-indocyanine green angiography features in optical coherence tomography angiography have been validated for PCV diagnosis and treatment response monitoring. Clinical trials provide new data on the safety and efficacy of various anti-vascular endothelial growth factor (anti-VEGF) agents as well as protocols that aim to improve the sustainability of treatments. In view of the myriads of emerging information, the panel gathered, reviewed, discussed, formulated and voted on the consensus and guidelines of PCV on four areas: 1) disease entity, 2) investigation and diagnosis, 3) treatment options, and 4) management protocol and future development in a five-point Likert scale (strongly agree, agree, neutral, disagree and strongly disagree). We proposed using a consensus score in which the maximum was 100. The summation of the respective "percentages" of experts voting for "agree" or "strongly agree" would be counted as the actual score. Consensus was achieved when the actual score of 75 or more was reached, which meant at least 75 % of the experts had voted for "strongly agree" or "agree" on the consensus statement concerned.

Keywords: Asia-Pacific Vitreo-retina Society (APVRS); Consensus and guidelines; Consensus score; Diagnosis and management; Polypoidal choroidal vasculopathy (PCV).

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Danny S.C. Ng: N/A Voraporn Chaikitmongkol: honoraria from Abbvie, Bayer, Roche for lecture fees and research grants from Bayer, Roche. Andrew Chang: consultant for Bayer, Novartis, Roche, Allergan, Alcon, Astellis, Apellis, and Zeiss opthea. Shih-Jen Chen: consultant for Roche, Bayer. Youxin Chen: advisor for Novartis, Bayer, Roche, Allergan, and Kanghong Biotech. Chui Ming Gemmy Cheung: grants, consultant, and speaker fees from Bayer, Novartis, Roche, Boehringer Ingelheim, Allergan, Zeiss, Topcon and supported by the National Medical Research Council Singapore Open Fund Large Collaborative Grant (NMRC/LCG/004/2018). Fumi Gomi: consultant, financial support, lecturer for Bayer, Novartis, Santen, Senju, Chugai, Kyowa Kirin and Nidek. Robyn Guymer: consultant for Novartis, Bayer, Apellis, Roche/Genentech. Judy E. Kim: consultant for Abbvie, Adverum, Apellis, Bausch &Lomb, Clearside Biomedical, DORC, Eyepoint, Genentech/Roche, Neurotech, Regeneron. Adrian Koh: consultant and lecture honoraria from Novartis, Bayer, Alcon, Allergan, Boehringer Mannheim, Carl Zeiss Meditec, Heidelberg Engineering, Topcon. Gregg T. Kokame: consultant for Roche, Bayer, Bausch and Lomb, Zeiss, research support for Genentech, Bayer, Regeneron, RegenxBio, Novartis, Iveric, Ophthea, Astellas, Adverum, speaker for Zeiss, Bausch and Lomb, Ophthea. Chi-Chun Lai: lecture honoraria from Novartis, Bayer, Allergan; Alcon., Research Grant: Novartis, Bayer, Roche. Timothy Y.Y. Lai: honoraria from Allergan, Bayer, Boehringer Ingelheim, Kanghong Biotech, Novartis, Ocular Therapeutix, Oculis, Roche for consultancy, research grants from Novartis and Roche. Won Ki Lee: consultant for Novartis, Bayer, Boehringer-Ingelheim, Roche and lecture fees from Novartis, Bayer, Roche. Yuichiro Ogura: consultant for Novartis, Bayer Holding, Alcon Japan, Wakamoto Pharmaceuticals, HOYA Corporation, Astellas Pharma, Senju Pharmaceutical, Boehringer Ingelheim, Chengdu Kanghong Biotechnology, Kyoto Drug Discovery & Development and lecture fees from Santen Pharmaceuticals, KOWA, Novartis, Bayer Holding, TOPCON, NIKON Healthcare Japan, Sanwa Kagaku, a former employee of Genentech. Srinivas Sadda: consultant: 4DMT, Abbvie/Allregan Inc., Alexion, Alnylam Pharmaceuticals, Amgen Inc., Apellis Pharmaceuticals, Inc., Astellas, Bayer Healthcare Pharmaceuticals, Biogen MA Inc., Boehringer Ingelheim, Carl Zeiss Meditec, ONL Therapeutics, Catalyst Pharmaceuticals Inc., CharacterBio, iCare/Centervue Inc., GENENTECH, Ocular Therapeutics, Eyepoint, Heidelberg Engineering, Hoffman La Roche, Ltd., Iveric Bio, Janssen Pharmaceuticals Inc., Nanoscope, Notal Vision Inc., Novartis Pharma AG, Optos Inc., Oxurion/Thrombogenics, Oyster Point Pharma, Regeneron Pharmaceuticals Inc., Samsung Bioepis, Topcon Medical Systems Inc, recipient (Honoraria): Carl Zeiss Meditec, Heidelberg Engineering, Nidek Incorporated, Novartis Pharma AG, Topcon Medical Systems Inc.; Roche, research Instruments: Carl Zeiss Meditec, Heidelberg Engineering, Optos Inc., Nidek, Topcon, iCare/Centervue, Intalight. Kelvin Y.C. Teo: consultant, lecturer for Bayer, Novartis and supported by National Medical Research Council Singapore Open Fund Large Collaborative Grant (NMRC/LCG/004/2018) and Transition award (MOH_TA-nov_19- 002). Tien Yin Wong: consultant for Abbvie Pte Ltd, Aldropika Therapeutics, Bayer, Boehringer-Ingelheim, Carl Zeiss, Genentech, Iveric Bio, Novartis, Opthea Limited, Plano, Quaerite Biopharm Research Ltd, Roche, Sanofi, Shanghai Henlius, fundings from National Key R&D Program (Grant No: 2022YFC2502800), National Natural Science Fund of China (Grant No: 82388101), Beijing Natural Science Foundation (Grant No: IS23096). Yasuo Yanagi: lecture and consultant fees: Alcon, Bayer, Boehringer Ingelheim, Chugai Pharmaceutical Co., Ltd., Janssen Pharmaceuticals, Micron Co., Ltd., Novartis, Santen Pharmaceutical, Senju Pharmaceutical. Dennis S.C. Lam: N/A PR: honoraria and consultancy from Roche and Bayer, research grants from Roche.

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Consensus and guidelines on diagnosis and management of polypoidal choroidal vasculopathy (PCV) from the Asia-Pacific Vitreo-retina Society (APVRS)

Affiliations

Consensus and guidelines on diagnosis and management of polypoidal choroidal vasculopathy (PCV) from the Asia-Pacific Vitreo-retina Society (APVRS)

Authors

Affiliations

Abstract

Conflict of interest statement

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Medical