Polypoidal choroidal vasculopathy

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The article presents literature review devoted to the issue of polypoidal choroidal vasculopathy. The studies of Russian and foreign researchers were reviewed. Epidemiological and clinical characteristics of polypoidal choroidal vasculopathy, diagnostic features and modern treatment methods, the results of clinical studies are presented. Polypoidal choroidal vasculopathy is a subtype of neoascular AMD with specific characteristics including predisposition of certain races, clinical features, serosanguineous complications of different severity, tendency to relapsing course of neovascularization and development of secondary serosanguineous exfoliation. It was registered most frequently in patients aged 50 to 65 years. Prevalence among Caucasians is 4 to 9.8%, and among Asians - 23.9 to 54.7%. Diagnosis of polypoidal choroidal vasculopathy requires the use of fluorescent angiography, indocyanine green angiography and optical coherence tomography. Polyps regression accordng to angiography is considered one of the aims of initial therapy of active polypoidal choroidal vasculopathy. According to Expert group of polypoidal choroidal vasculopathy, while using laser photocoagulation and photodynamic therapy, affecting both polyps and vasculature is required. As a result of the analysis of population studies, the results of treatment with laser coagulation, photodynamic therapy (independently and in combination with angiogenesis inhibitors) and monotherapy with angiogenesis inhibitors were demonstrated. Regardless of the achieved results of polypoidal choroidal vasculopathy diagnosis, the treatment issues require further investigation. Additional studies are required to evaluate long-term correlation between initial polyp regression, relapses, response to repeated therapy and functional results.

About the authors

E A Abdulaeva

Kazan State Medical Academy

Author for correspondence.
Email: abd@inbox.ru
Kazan, Russia


  1. Yannuzzi L.A. Idiopathic polypoidal choroidal vasculopathy. The Macula Society Meeting. Miami. 1982; 1.
  2. Kleiner R.C., Brucker A.J., Johnston R.L. The posterior uveal bleeding syndrome. Retina. 1990; 10: 9-17. doi: 10.1097/00006982-199001010-00002.
  3. Yannuzzi L.A., Sorenson J., Spaide R.F., Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina. 1990; 10: 1-8. doi: 10.1097/00006982-199001010-00001.
  4. Yannuzzi L.A., Wong D.W., Sforzolini B.S. et al. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch. Ophthalmol. 1999; 117: 1503-1510. doi: 10.1001/archopht.117.11.1503.
  5. Koh A.H.C., Chen L.-J., Chen S.-J. et al. Polypoidal choroidal vasculopathy. Evidence-Based Guidelines for Clinical Diagnosis and Treatment. Retina. 2013; 33: 686-716. doi: 10.1097/IAE.0b013e3182852446.
  6. Imamura Y., Engelbert M., Iida T. et al. Polypoidal choroidal vasculopathy: a review. Surv. Ophthalmol. 2010; 55: 501-515. doi: 10.1016/j.survophthal.2010.03.004.
  7. Byeon S.H., Lee S.C., Oh H.S. et al. Incidence and clinical patterns of polypoidal choroidal vasculopathy in Korean patients. Jpn. J. Ophthalmol. 2008; 52: 57-62. doi: 10.1007/s10384-007-0498-2.
  8. Lim T.H., Laude A., Tan C.S. Polypoidal choroidal vasculopathy: an angiographic discussion. Eye (Lond.). 2010; 24: 483-490. doi: 10.1038/eye.2009.323.
  9. Nakashizuka H., Mitsumata M., Okisaka S. et al. Clinicopathologic findings in polypoidal choroidal vasculopathy. Invest. Ophthalmol. Vis. Sci. 2008; 49: 4729-4737. doi: 10.1167/iovs.08-2134.
  10. Tsujikawa A., Sasahara M., Otani A. et al. Pigment epithelial detachment in polypoidal choroidal vasculopathy. Am. J. Ophthalmol. 2007; 143 (1): 102-111. doi: 10.1016/j.ajo.2006.08.025.
  11. Musashi K., Tsujikawa A., Hirami Y. et al. Microrips of the retinal pigment epithelium in polypoidal choroidal vasculopathy. Am. J. Ophthalmol. 2007; 143 (5): 883-885. doi: 10.1016/j.ajo.2006.12.024.
  12. Maruko I., Iida T., Saito M. et al. Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am. J. Ophthalmol. 2007; 144 (1): 15-22. doi: 10.1016/j.ajo.2007.03.047.
  13. Gomi F., Sawa M., Mitarai K. et al. Angiographic lesion of polypoidal choroidal vasculopathy on indocyanine green and fluorescence angiography. Graefes Arch. Clin. Exp. Ophthalmol. 2007; 245 (10): 1421-1427. doi: 10.1007/s00417-007-0564-y.
  14. Okubo A., Arimura N., Abematsu N., Sakamoto T. Predictable signs of benign course of polypoidal choroidal vasculopathy: based upon the long-term observation of non-treated eyes. Acta. Ophthalmol. 2010; 88: e107-e114. doi: 10.1111/j.1755-3768.2009.01850.x.
  15. Yuzawa M., Mori R., Kawamura A. The origins of polypoidal choroidal vasculopathy. Br. J. Ophthalmol. 2005; 89: 602-607. doi: 10.1136/bjo.2004.049296.
  16. Japanese Study Group of Polypoidal Choroidal Vasculopathy. Criteria for diagnosis of polypoidal choroidal vasculopathy. Nippon Ganka Gakkai Zasshi. 2005; 109: 417-427.
  17. Sato T., Kishi S., Watanabe G. et al. Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy. Retina. 2007; 27 (5): 589-594. doi: 10.1097/01.iae.0000249386.63482.05.
  18. Uyama M., Wada M., Nagai Y. et al. Polypoidal choroidal vasculopathy: natural history. Am. J. Ophthalmol. 2002; 133: 639-648. doi: 10.1016/S0002-9394(02)01404-6.
  19. Lee W.K., Lee P.Y., Lee S.K. Photodynamic therapy for polypoidal choroidal vasculopathy: Vaso-occlusive effect on the branching vascular network and origin of recurrence. Jpn. J. Ophthalmol. 2008; 52: 108-115. doi: 10.1007/s10384-007-0501-y.
  20. Wakabayashi T., Gomi F., Sawa M. et al. Intravitreal bevacizumab for exudative branching vascular networks in polypoidal choroidal vasculopathy. Br. J. Ophthalmol. 2012; 96: 394-399. doi: 10.1136/bjo.2011.204123.
  21. Chan W.M., Lam D.S., Lai T.Y. et al. Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology. 2004; 111: 1576-1584. doi: 10.1016/j.ophtha.2003.12.056.
  22. Honda S., Kurimoto Y., Kagotani Y. et al. Photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a 30-month multicenter study in Hyogo, Japan. Jpn. J. Ophthalmol. 2009; 53: 593-597. doi: 10.1007/s10384-009-0741-0.
  23. Koh A., Lee W.K., Chen L.J. et al. EVEREST study: efficacy and safety of verteporfin PDT in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina. 2012; 32: 1453-1464. doi: 10.1097/IAE.0b013e31824f91e8.
  24. Yamashita A., Shiraga F., Shiragami C. et al. One-year results of reduced-fluence photodynamic therapy for polypoidal choroidal vasculopathy. Am. J. Ophthalmol. 2010; 149: 465-471. doi: 10.1016/j.ajo.2009.09.020.
  25. Lee M.W., Yeo I., Wong D., Ang C.L. Argon laser photocoagulation for the treatment of polypoidal choroidal vasculopathy. Eye (Lond.). 2009; 23: 145-148. doi: 10.1038/sj.eye.6702955.
  26. Akaza E., Mori R., Yuzawa M. Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy. Retina. 2008; 28: 717-722. doi: 10.1097/IAE.0b013e31816577cb.
  27. Akaza E., Yuzawa M., Mori R. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy. Jpn. J. Ophthalmol. 2011; 55: 39-44. DOI : 10.1007/s10384-010-0886-x.
  28. Tomita K., Tsujikawa A., Yamashiro K. et al. Treatment of polypoidal choroidal vasculopathy with photodynamic therapy combined with intravitreal injections of ranibizumab. Am. J. Ophthalmol. 2012; 153: 68-80.e1. doi: 10.1016/j.ajo.2011.07.001.
  29. Romano M.R., Cipollone U., Semeraro F. et al. Combined photodynamic therapy and intravitreal bevacizumab for idiopathic polypoidal choroidal vasculopathy: one-year follow-up. Clin. Ophthalmol. 2010; 4: 1237-1241. doi: 10.2147/OPTH.S12577.
  30. Kim M., Kim K., Kim D.G. et al. Two-year results of photodynamic therapy combined with intravitreal anti-vascular endothelial growth factor for polypoidal choroidal vasculopathy. Ophthalmologica. 2011; 226: 205-213. doi: 10.1159/000330793.
  31. Nakata I., Yamashiro K., Yamada R. et al. Genetic variants in pigment epithelium-derived factor influence response of polypoidal choroidal vasculopathy to photodynamic therapy. Ophthalmology. 2011; 118: 1408-1415. doi: 10.1016/j.ophtha.2010.12.011.
  32. Matsuoka M., Ogata N., Otsuji T. et al. Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy. Br. J. Ophthalmol. 2004; 88: 809-815. doi: 10.1136/bjo.2003.032466.
  33. Kokame G.T., Yeung L., Lai J.C. Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results. Br. J. Ophthalmol. 2010; 94: 297-301. doi: 10.1136/bjo.2008.150029.
  34. Hikichi T., Kitamei H., Shioya S. et al. Relation between changes in foveal choroidal thickness and 1-year results of ranibizumab therapy for polypoidal choroidal vasculopathy. Br. J. Ophthalmol. 2014; 98: 1201-1204. doi: 10.1136/bjophthalmol-2013-304555.
  35. Kawashima Y., Oishi A., Tsujikawa A. et al. Effects of aflibercept for ranibizumabresistant neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. Graefes Arch. Clin. Exp. Ophthalmol. 2015; 253: 1471-1477. doi: 10.1007/s00417-014-2838-5.
  36. Ijiri S., Sugiyama K. Short-term efficacy of intravitreal aflibercept for patients with treatment-naı¨ve polypoidal choroidal vasculopathy. Graefes Arch. Clin. Exp. Ophthalmol. 2015; 253: 351-357. doi: 10.1007/s00417-014-2707-2.
  37. Saito M., Kano M., Itagaki K. et al. Switching to intravitreal aflibercept injection for polypoidal choroidal vasculopathy refractory to ranibizumab. Retina. 2014; 34: 2192-2201. doi: 10.1097/IAE.0000000000000236.

© 2017 Abdulaeva E.A.

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