New Concepts for the Diagnosis of Polypoidal Choroidal Vasculopathy

Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration (nAMD) that is characterized by a branching neovascular network and polypoidal lesions. It is important to differentiate PCV from typical nAMD as there are differences in treatment response between s...

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Bibliographic Details
Published in:Diagnostics (Basel) 2023-05, Vol.13 (10), p.1680
Main Authors: Zhao, Jinzhi, Chandrasekaran, Priya R, Cheong, Kai Xiong, Wong, Mark, Teo, Kelvin
Format: Article
Language:English
Subjects:
Accuracy
color fundus photograph
Diagnostic imaging
en face OCT-complex RPE elevation
Macular degeneration
Medical imaging
Medical research
Medicine, Experimental
non-ICGA
OCT
PCV
Retina
Review
sub-RPE ring-like lesion
Tomography
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Summary:Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration (nAMD) that is characterized by a branching neovascular network and polypoidal lesions. It is important to differentiate PCV from typical nAMD as there are differences in treatment response between subtypes. Indocyanine green angiography (ICGA) is the gold standard for diagnosing PCV; however, ICGA is an invasive detection method and impractical for extensive use for regular long-term monitoring. In addition, access to ICGA may be limited in some settings. The purpose of this review is to summarize the utilization of multimodal imaging modalities (color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), and fundus autofluorescence (FAF)) in differentiating PCV from typical nAMD and predicting disease activity and prognosis. In particular, OCT shows tremendous potential in diagnosing PCV. Characteristics such as subretinal pigment epithelium (RPE) ring-like lesion, en face OCT-complex RPE elevation, and sharp-peaked pigment epithelial detachment provide high sensitivity and specificity for differentiating PCV from nAMD. With the use of more practical, non-ICGA imaging modalities, the diagnosis of PCV can be more easily made and treatment tailored as necessary for optimal outcomes.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics13101680