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

被引:203
作者
Koh, Adrian H. C.
Chen, Lee-Jen [1 ]
Chen, Shih-Jen [2 ]
Chen, Youxin [3 ]
Giridhar, Anantharam [4 ]
Iida, Tomohiro [5 ,6 ]
Kim, Hakyoung [7 ]
Lai, Timothy Yuk Yau
Lee, Won Ki [8 ]
Li, Xiaoxin [9 ]
Lim, Tock Han [10 ,11 ]
Ruamviboonsuk, Paisan [12 ]
Sharma, Tarun [13 ]
Tang, Shibo [14 ]
Yuzawa, Mitsuko [15 ]
机构
[1] Mackay Mem Hosp, Dept Ophthalmol, Taipei, Taiwan
[2] Natl Yang Ming Univ, Taipei Vet Gen Hosp, Dept Ophthalmol, Taipei 112, Taiwan
[3] Peking Union Med Coll Hosp, Dept Ophthalmol, Beijing, Peoples R China
[4] Giridhar Eye Inst, Kochi, Kerala, India
[5] Tokyo Womens Med Univ, Dept Ophthalmol, Tokyo, Japan
[6] Fukushima Med Univ, Dept Ophthalmol, Fukushima, Japan
[7] Hallym Univ, Dept Ophthalmol, Kangnam Sacred Heart Hosp, Seoul, South Korea
[8] Chinese Univ Hong Kong, Dept Ophthalmol & Visual Sci, Shatin, Hong Kong, Peoples R China
[9] Catholic Univ Korea, Seoul St Marys Hosp, Dept Ophthalmol, Seoul, South Korea
[10] Peking Univ, Peoples Hosp, Dept Ophthalmol, Beijing 100871, Peoples R China
[11] Tan Tock Seng Hosp, Natl Healthcare Grp Eye Inst, Singapore, Singapore
[12] Rajavithi Hosp, Dept Ophthalmol, Bangkok, Thailand
[13] Sankara Nethralaya, Madras, Tamil Nadu, India
[14] Sun Yat Sen Univ, Zhong Shan Ophthalm Ctr, Guangzhou 510275, Guangdong, Peoples R China
[15] Surugadai Nihon Univ, Dept Ophthalmol, Chiyoda Ku, Tokyo, Japan
来源
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES | 2013年 / 33卷 / 04期
关键词
indocyanine green angiography; pigment epithelium detachment; polypoidal choroidal vasculopathy; ranibizumab; verteporfin PDT; INDOCYANINE GREEN ANGIOGRAPHY; ENDOTHELIAL GROWTH-FACTOR; VERTEPORFIN PHOTODYNAMIC THERAPY; INTRAVITREAL BEVACIZUMAB INJECTION; PIGMENT EPITHELIAL DETACHMENT; OPTICAL COHERENCE TOMOGRAPHY; BRANCHING VASCULAR NETWORKS; MACULAR DEGENERATION; CLINICOPATHOLOGICAL CORRELATION; LASER PHOTOCOAGULATION;
D O I
10.1097/IAE.0b013e3182852446
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
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 x 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. RETINA 33:686-716, 2013
引用
收藏
页码:686 / 716
页数:31
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