Modern aspects of polypoidal choroidal vasculopathy diagnosis and treatment

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Abstract

Polypoidal choroidal vasculopathy (PCV) is one of the choroidal neovascularization forms, being a subtype of neovascular age-related macular degeneration (nAMD). These two conditions share many characteristics, while PCV has some distinctive features with aneurysmal dilatations (polyps) at the end of abnormal branching vascular network being the most specific of them. Low documented incidence of PCV in European population (up to 13%) may be related to the absence of indocyanin-green angiography (ICG) – the only reliable method for PCV diagnosis confirmation – in routine clinical practice. In that regard, there should be a universal method of treatment suitable for any patient with nAMD irrespectively of whether he or she has PCV. To date, there is no common approach to PCV treatment – anti-VEGF therapy, photodynamic therapy (PDT), and combination of these methods are used in clinical practice. Key diagnostic criteria helping to suspect the presence of PCV without ICG as well as results of clinical trials aimed at assessing effectiveness of different anti-VEGF agents as monotherapy or in combination with PDT are described in this article.

About the authors

Konstantin V. Sokolov

Eye Microsurgery Center Primorskiy

Author for correspondence.
Email: konsokolov@yandex.ru

PhD, Head of Surgical Department

Russian Federation, Vladivostok

Alexey K. Smirnov

Eye Microsurgery Center Primorskiy

Email: smirnov-a-k@mail.ru

ophthalmologist

Russian Federation, Vladivostok

References

  1. Yannuzzi LA, Sorenson J, Spaide RF, Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina. 1990;10(1):1-8. https://doi.org/10.1097/00006982-199001010-00001.
  2. Cheung CM, Lai TY, Ruamviboonsuk P, et al. Polypoidal choroidal vasculopathy: definition, pathogenesis, diagnosis, and management. Ophthalmology. 2018;125(5):708-724. https://doi.org/10.1016/j.ophtha.2017.11.019.
  3. Dansingani KK, Gal-Or O, Sadda SR, et al. Understanding aneurysmal type 1 neovascularization (polypoidal choroidal vasculopathy): a lesson in the taxonomy of ‘expanded spectra’ – a review. Clin Exp Ophthalmol. 2018;46(2):189-200. https://doi.org/10.1111/ceo.13114.
  4. Takahashi K, Ishibashi T, Ogur Y, et al. [Classification and diagnostic criteria of age-related macular degeneration. (In Japanese)]. Nippon Ganka Gakkai Zasshi. 2008;112(12):1076-1084.
  5. Шаимов Т.Б., Панова И.Е., Шаимова В.А. Дифференциально-диагностические критерии в диагностике полипоидной хориоидальной васкулопатии как варианта течения неоваскулярной стадии возрастной макулярной дегенерации // Современные технологии в офтальмологии. – 2017. – № 1. – C. 335–339. [Shaimov TB, Panova IE, Shaimova VA. Differencialno-diagnosticheskie kriterii v diagnostike polipoidnoi chorioidal’noi vaskulopatii kak varianta techeniya neovasculyarnoi stadii vozrastnoi maculyarnoi degeneracii. Sovremennye technologii v oftal’mologii. 2017;(1):335-339. (In Russ.)]
  6. Koh AH, Expert PCV Panel, Chen LJ, et al. Polypoidal choroidal vasculopathy: evidence-based guidelines for clinical diagnosis and treatment. Retina. 2013;33(4):686-716. https://doi.org/10.1097/IAE.0b013e3182852446.
  7. Koh A, Lai TY, Takahashi K, et al. Efficacy and Safety of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy: a randomized clinical trial. JAMA Ophthalmol. 2017;135(11):1206-1213. https://doi.org/10.1001/jamaophthalmol.2017.4030.
  8. Педанова Е.К., Дога А.В. Лечение полипоидной хориоидальной васкулопатии: фотодинамическая терапия, анти-VEGF-терапия или их комбинация? Обзор современных клинических исследований // Офтальмология. – 2019. – Т. 16. – № 2. – С. 151–158. [Pedanova EK, Doga AV. Polypoidal choroidal vasculopathy treatment: photodynamic therapy, anti-VEGF monotherapy or combination. Review of clinical studies. Ophthalmology. 2019;16(2):151-158. (In Russ.)]. https://doi.org/10.18008/1816-5095-2019-2-151-158.
  9. Laude A, Cackett PD, Vithana EN, et al. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease? Prog Retin Eye Res. 2010;29(1):19-29. https://doi.org/10.1016/j.preteyeres.2009.10.001.
  10. Дога А.В., Педанова Е.К., Володин П.Л., Майорова А.М. Первые результаты фотодинамической терапии при полипоидной хориоидальной васкулопатии как подтипе возрастной макулярной дегенерации // Современные технологии в офтальмологии. – 2017. – № 1. – С. 70–73. [Doga AV, Pedanova EK, Volodin PL, Mayorova AM. Pervye rezul’taty fotodinamicheskoi terapii pri polypoidnoi chorioidal’noi vasculopatii kak podtipe vozrastnoi makulyarnoi degeneracii. Sovremennye technologii v oftal’mologii. 2017;(1):70-73. (In Russ.)]
  11. Будзинская М.В. Возрастная макулярная дегенерация // Вестник офтальмологии. – 2014. – Т. 130. – № 6. – С. 56–61. [Budzinskaia MV. Age-related macular degeneration. Annals of ophthalmology. 2014;130(6):56-61. (In Russ.)]
  12. Japanese Study Group of Polypoidal Choroidal Vasculopathy. [Criteria for diagnosis of polypoidal choroidal vasculopathy. (In Japanese)]. Nippon Ganka Gakkai Zasshi. 2005;109(7): 417-427.
  13. Kim SW, Oh J, Kwon SS, et al. Comparison of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy. Retina. 2011;31(9):1904-1911. https://doi.org/10.1097/IAE.0b013e31821801c5.
  14. Rishi P, Rishi E, Mathur G, Raval V. Ocular perfusion pressure and choroidal thickness in eyes with polypoidal choroidal vasculopathy, wet-age-related macular degeneration, and normals. Eye (Lond). 2013;27(9):1038-1043. https://doi.org/10.1038/eye.2013.106.
  15. Jirarattanasopa P, Ooto S, Nakata I, et al. Choroidal thickness, vascular hyperpermeability, and complement factor H in age-related macular degeneration and polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci. 2012;53(7):3663-3672. https://doi.org/10.1167/iovs.12-9619.
  16. Koizumi H, Yamagishi T, Yamazaki T, et al. Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol. 2011;249(8): 1123-1128. https://doi.org/10.1007/s00417-011-1620-1.
  17. Lee H, Bae K, Kang SW, et al. Morphologic characteristics of choroid in the major choroidal thickening diseases, studied by optical coherence tomography. PLoS One. 2016;11(1):e0147139. https://doi.org/10.1371/journal.pone.0147139.
  18. Stanga PE, Lim JI, Hamilton P. Indocyanine green angiography in chorioretinal diseases: indications and interpretation: an evidence-based update. Ophthalmology. 2003;110(1):15-21. https://doi.org/10.1016/s0161-6420(02)01563-4.
  19. Lipson BK, Yannuzzi LA. Complications of intravenous fluorescein injections. Int Ophthalmol Clin. 1989;29(3):200-205. https://doi.org/10.1097/00004397-198902930-00011.
  20. Olsen TW, Lim JI, Capone A Jr, et al. Anaphylactic shock following indocyanine green angiography. Arch Ophthalmol. 1996;114(1):97. https://doi.org/10.1001/archopht.1996.01100130093018.
  21. Azab M, Benchaboune M, Blinder KJ, et al. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: meta-analysis of 2-year safety results in three randomized clinical trials: treatment of age-related macular degeneration with photodynamic therapy and verteporfin in photodynamic therapy study report no. 4. Retina. 2004;24(1):1-12. https://doi.org/10.1097/00006982-200402000-00001.
  22. Akaza E, Yuzawa M, Mori R. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy. Jpn J Ophthalmol. 2011;55(1):39-44. https://doi.org/10.1007/s10384-010-0886-x.
  23. Wong CW, Cheung CM, Mathur R, et al. Three-year results of polypoidal choroidal vasculopathy treated with photodynamic therapy: retrospective study and systematic review. Retina. 2015;35(8):1577-1593. https://doi.org/10.1097/IAE. 0000000000000499.
  24. Дога А.В., Педанова Е.К., Володин П.Л., Майорова А.М. Современные аспекты диагностики и лечения полипоидной хориоидальной васкулопатии // Офтальмохирургия. – 2017. – № 1. – С. 88–92. [Doga AV, Pedanova EK, Volodin PL, Mayorova AM. Current aspects of diagnosis and treatment of polypoidal choroidal vasculopathy. Ophthalmosurgery. 2017;(1):88-92. (In Russ.)]. https://doi.org/10.25276/0235-4160-2017-1-88-92.
  25. Oishi A, Kojima H, Mandai M, et al. Comparison of the effect of ranibizumab and verteporfin for polypoidal choroidal vasculopathy: 12-month LAPTOP study results. Am J Ophthalmol. 2013;156(4):644-651. https://doi.org/10.1016/j.ajo. 2013.05.024.
  26. Ogino K, Tsujikawa A, Yamashiro K, et al. Intravitreal injection of ranibizumab for recovery of macular function in eyes with subfoveal polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci. 2013;54(5):3771-3779. https://doi.org/10.1167/iovs.12-11494.
  27. Koh A, Lee WK, Chen LJ, et al. Everest study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina. 2012;32(8):1453-1464. https://doi.org/10.1097/IAE.0b013e31824f91e8.
  28. Инструкция по медицинскому применению лекарственного препарата Луцентис (ЛСР-004567 от 27.04.2017) [интернет]. [Instruktsiya po meditsinskomu primeneniyu lekarstvennogo sredstva Lutsentis (LSR-004567; approved on 27.04.2017). (In Russ.)]. Доступно по: https://www.novartis.ru/sites/www.novartis.ru/files/2017-04-27-lucentis-npiv0-full-version.pdf. Ссылка активна на 16.07.2019.
  29. Инструкция по медицинскому применению лекарственного препарата Эйлеа (ЛП-003544 от 17.04.2019) [интернет]. [Instruktsiya po meditsinskomu primeneniyu lekarstvennogo sredstva Eylea (LP-003544; approved on 17.04.2019). (In Russ.)]. Доступно по: https://apteka.hk/instrukciya/eylea.pdf. Ссылка активна на 16.07.2019.
  30. Ogura Y, Terasaki H, Gomi F, et al. Efficacy and safety of intravitreal aflibercept injection in wet age-related macular degeneration: outcomes in the Japanese subgroup of the VIEW 2 study. Br J Ophthalmol. 2015;99(1):92-97. https://doi.org/10.1136/bjophthalmol-2014-305076.
  31. Lee WK, Iida T, Ogura Y, et al. Efficacy and safety of intravitreal aflibercept for polypoidal choroidal vasculopathy in the planet study: a randomized clinical trial. JAMA Ophthalmol. 2018;136(7):786-793. https://doi.org/10.1001/jamaophthalmol.2018.1804.
  32. Tien YW, Yuichiro O, Won KL et al. Efficacy and safety of intravitreal aflibercept for polypoidal choroidal vasculopathy: 2-year results of the planet study. American Journal of Ophthalmology. 2019;204:80-89. https://doi.org/10.1016/j.ajo.2019.02.027.
  33. Morimoto M, Matsumoto H, Mimura K, Akiyama H. Two-year results of a treat-and-extend regimen with aflibercept for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol. 2017;255(10):1891-1897. https://doi.org/10.1007/s00417-017-3718-6.
  34. Oshima Y, Kimoto K, Yoshida N, et al. One-year outcomes following intravitreal aflibercept for polypoidal choroidal vasculopathy in Japanese patients: the apollo study. Ophthalmologica. 2017;238(3):163-171. https://doi.org/10.1159/ 000477448.
  35. Hosokawa M, Morizane Y, Hirano M, et al. One-year outcomes of a treat-and-extend regimen of intravitreal aflibercept for polypoidal choroidal vasculopathy. Jpn J Ophthalmol. 2017;61(2): 150-158. https://doi.org/10.1007/s10384-016-0492-7.
  36. Wolff B, Vasseur V, Cahuzac A, et al. Aflibercept treatment in polypoidal choroidal vasculopathy: results of a prospective study in a Caucasian population. Ophthalmologica. 2018;240(4):208-212. https://doi.org/10.1159/000488808.

Copyright (c) 2019 Sokolov K.V., Smirnov A.K.

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