POLYPOIDAL CHOROIDAL VASCULOPATHY: CURRENT DIAGNOSIS IN THE ERA OF MULTIMODAL IMAGING
DOI:
https://doi.org/10.29303/jku.v11i3.780Keywords:
diagnosis, polypoidal choroidal vasculopathy, fluorescein angiography, indocyanine green angiography, ocular coherence tomography, ocular coherence tomography angiography, imagingAbstract
Polypoidal choroidal vasculopathy (PCV) is a major cause of visual disability in most Asian populations due to exudative maculopathy. PCV is a disease that is often either underdiagnosed or misdiagnosed considering that the diagnosis is highly dependent on imaging modalities. Diagnostic modalities that can be used for PCV are fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), ocular coherence tomography (OCT), en face OCT, ocular coherence tomography angiography (OCTA), and even artificial intelligence. Despite of ICGA with its invasive nature, limited availability, and relatively expensive cost, it still remains as a gold standard diagnostic modality for PCV. Clinicians can use various other investigation modalities to assist in diagnosing PCV considering the limitations of ICGA based on various studies that have been carried out. Various diagnostic modalities, both existing and new, can be considered for use and combined to increase the accuracy of non-invasive diagnostics. Clinicians must also continue to improve their skills and knowledge amid the development of diagnostic technology in the era of multi-modality imaging.
References
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33. Cheung CMG, Lai TYY, Ruamviboonsuk P, Chen SJ, Chen Y, Freund KB, et al. Polypoidal Choroidal Vasculopathy. Ophthalmology. 2018 May;125(5):708–24.
34. Semoun O, Coscas F, Coscas G, Lalloum F, Srour M, Souied EH. En face enhanced depth imaging optical coherence tomography of polypoidal choroidal vasculopathy. British Journal of Ophthalmology. 2016 Aug;100(8):1028–34.
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45. Yang J, Zhang C, Wang E, Chen Y, Yu W. Utility of a public-available artificial intelligence in diagnosis of polypoidal choroidal vasculopathy. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2020 Jan 1;258(1):17–21.
46. Xu Z, Wang W, Yang J, Zhao J, Ding D, He F, et al. Automated diagnoses of age-related macular degeneration and polypoidal choroidal vasculopathy using bi-modal deep convolutional neural networks. British Journal of Ophthalmology. 2021 Apr;105(4):561–6.
47. Tsai YY, Lin WY, Chen SJ, Ruamviboonsuk P, King CH, Tsai CL. Diagnosis of Polypoidal Choroidal Vasculopathy From Fluorescein Angiography Using Deep Learning. Translational Vision Science & Technology. 2022 Feb 3;11(2):6.
48. Chou YB, Hsu CH, Chen WS, Chen SJ, Hwang DK, Huang YM, et al. Deep learning and ensemble stacking technique for differentiating polypoidal choroidal vasculopathy from neovascular age-related macular degeneration. Scientific Reports. 2021 Dec 30;11(1):7130.
2. Anantharaman G, Sheth J, Bhende M, Narayanan R, Natarajan S, Rajendran A, et al. Polypoidal choroidal vasculopathy: Pearls in diagnosis and management. Vol. 66, Indian Journal of Ophthalmology. Medknow Publications; 2018. p. 896–908.
3. Li Y, You QS, Wei W bin, Xu J, Chen CX, Wang YX, et al. Polypoidal Choroidal Vasculopathy in Adult Chinese: The Beijing Eye Study. Ophthalmology. 2014 Nov;121(11):2290–1.
4. Fujiwara K, Yasuda M, Hata J, Oshima Y, Hashimoto S, Yoshitomi T, et al. Prevalence and Risk Factors for Polypoidal Choroidal Vasculopathy in a General Japanese Population: The Hisayama Study. Seminars in Ophthalmology. 2018 Aug 18;33(6):813–9.
5. Sho K, Takahashi K, Yamada H, Wada M, Nagai Y, Otsuji T, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol. 2003 Oct;121(10):1392–6.
6. Kumar M, Moptom SE, Sen P, Khetan V, Bhende M, Sivaprasad S, et al. Prevalence of polypoidal choroidal vasculopathy in Indian population: Risk factors, clinical and imaging characteristics. PLOS ONE. 2020 Apr 28;15(4):e0231901.
7. Chang YC, Wu WC. Polypoidal Choroidal Vasculopathy in Taiwanese Patients. Ophthalmic Surgery, Lasers and Imaging Retina. 2009 Jan;40(6):576–81.
8. Byeon SH, Lee SC, Oh HS, Kim SS, Koh HJ, Kwon OW. Incidence and clinical patterns of polypoidal choroidal vasculopathy in Korean patients. Japanese Journal of Ophthalmology. 2008 Feb 28;52(1):57–62.
9. Liu Y, Wen F, Huang S, Luo G, Yan H, Sun Z, et al. Subtype lesions of neovascular age-related macular degeneration in Chinese patients. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2007 Sep 10;245(10):1441–5.
10. Yadav S, Parry DG, Beare NA v, Pearce IA. Polypoidal choroidal vasculopathy: a common type of neovascular age-related macular degeneration in Caucasians. British Journal of Ophthalmology. 2017 Oct;101(10):1377–80.
11. Ladas ID, Rouvas AA, Moschos MM, Synodinos EE, Karagiannis DA, Koutsandrea CN. Polypoidal choroidal vasculopathy and exudative age-related macular degeneration in Greek population. Eye. 2004 May 7;18(5):455–9.
12. Sun X, Yang S, Zhao J. Resistance to anti-VEGF therapy in neovascular age-related macular degeneration: a comprehensive review. Drug Design, Development and Therapy. 2016 Jun;1857.
13. Lam WC, Choudhry N, Wong D. Polypoidal choroidal vasculopathy in Canada. Canadian Journal of Ophthalmology. 2020 Jun;55(3):199–211.
14. Gomi F, Tano Y. Polypoidal choroidal vasculopathy and treatments. Current Opinion in Ophthalmology. 2008 May;19(3):208–12.
15. Maruko I, Iida T, Saito M, Nagayama D. Combined cases of polypoidal choroidal vasculopathy and typical age-related macular degeneration. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2010 Mar 14;248(3):361–8.
16. Maruko I, Iida T, Saito M, Nagayama D, Saito K. Clinical Characteristics of Exudative Age-related Macular Degeneration in Japanese Patients. American Journal of Ophthalmology. 2007 Jul;144(1):15-22.e2.
17. Chaikitmongkol V, Cheung CMG, Koizumi H, Govindahar V, Chhablani J, Lai TYY. Latest developments in polypoidal choroidal vasculopathy: Epidemiology, etiology, diagnosis, and treatment. Vol. 9, Asia-Pacific Journal of Ophthalmology. Lippincott Williams and Wilkins; 2020. p. 260–8.
18. Cheung CMG, Lai TYY, Teo K, Ruamviboonsuk P, Chen SJ, Kim JE, et al. Polypoidal Choroidal Vasculopathy. Ophthalmology. 2021 Mar;128(3):443–52.
19. Koh AHC, Expert PCV Panel, Chen LJ, Chen SJ, Chen Y, Giridhar A, et al. Polypoidal choroidal vasculopathy: evidence-based guidelines for clinical diagnosis and treatment. Retina. 2013 Apr;33(4):686–716.
20. Koh A, Lee WK, Chen LJ, Chen SJ, Hashad Y, Kim H, 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 Sep;32(8):1453–64.
21. Kwok AKH, Lai TYY, Chan CWN, Neoh EL, Lam DSC. Polypoidal choroidal vasculopathy in Chinese patients. British Journal of Ophthalmology. 2002 Aug 1;86(8):892–7.
22. Anantharaman G, Ramkumar G, Gopalakrishnan M, Rajput A. Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients. Indian Journal of Ophthalmology. 2010;58(5):399.
23. Japanese Study Group of Polypoidal Choroidal Vasculopathy. [Criteria for diagnosis of polypoidal choroidal vasculopathy]. Nippon Ganka Gakkai Zasshi. 2005 Jul;109(7):417–27.
24. Chaikitmongkol V, Kong J, Khunsongkiet P, Patikulsila D, Sachdeva M, Chavengsaksongkram P, et al. Sensitivity and Specificity of Potential Diagnostic Features Detected Using Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography for Polypoidal Choroidal Vasculopathy. JAMA Ophthalmology. 2019 Jun 1;137(6):661.
25. Tan CSH, Ngo WK, Lim LW, Lim TH. A novel classification of the vascular patterns of polypoidal choroidal vasculopathy and its relation to clinical outcomes. In: British Journal of Ophthalmology. BMJ Publishing Group; 2014. p. 1528–33.
26. Gomi F, Sawa M, Mitarai K, Tsujikawa M, Tano Y. Angiographic lesion of polypoidal choroidal vasculopathy on indocyanine green and fluorescein angiography. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2007 Oct;245(10):1421–7.
27. Desmettre T, Devoisselle JM, Mordon S. Fluorescence Properties and Metabolic Features of Indocyanine Green (ICG) as Related to Angiography. Survey of Ophthalmology. 2000 Jul;45(1):15–27.
28. Kang SW, Chung SE, Shin WJ, Lee JH. Polypoidal choroidal vasculopathy and late geographic hyperfluorescence on indocyanine green angiography. British Journal of Ophthalmology. 2009 Jun 1;93(6):759–64.
29. Gemmy Cheung CM, Laude A, Wong W, Mathur R, Chan CM, Wong E, et al. Improved Specificity Of Polypoidal Choroidal Vasculopathy Diagnosis Using A Modified Everest Criteria. Retina. 2015 Jul;35(7):1375–80.
30. Alshahrani S, al Shamsi H, al Kahtani E, Ghazi N. Spectral-domain optical coherence tomography findings in polypoidal choroidal vasculopathy suggest a type 1 neovascular growth pattern. Clinical Ophthalmology. 2014 Sep;1689.
31. de Salvo G, Vaz-Pereira S, Keane PA, Tufail A, Liew G. Sensitivity and specificity of spectral-domain optical coherence tomography in detecting idiopathic polypoidal choroidal vasculopathy. American Journal of Ophthalmology. 2014 Dec 1;158(6):1228-1238.e1.
32. Liu R, Li J, Li Z, Yu S, Yang Y, Yan H, et al. Distinguishing Polypoidal Choroidal Vasculopathy From Typical Neovascular Age-Related Macular Degeneration Based On Spectral Domain Optical Coherence Tomography. Retina. 2016 Apr;36(4):778–86.
33. Cheung CMG, Lai TYY, Ruamviboonsuk P, Chen SJ, Chen Y, Freund KB, et al. Polypoidal Choroidal Vasculopathy. Ophthalmology. 2018 May;125(5):708–24.
34. Semoun O, Coscas F, Coscas G, Lalloum F, Srour M, Souied EH. En face enhanced depth imaging optical coherence tomography of polypoidal choroidal vasculopathy. British Journal of Ophthalmology. 2016 Aug;100(8):1028–34.
35. Lau T, Wong I, Iu L, Chhablani J, Yong T, Hideki K, et al. En-face optical coherence tomography in the diagnosis and management of age-related macular degeneration and polypoidal choroidal vasculopathy. Indian Journal of Ophthalmology. 2015;63(5):378.
36. de Carlo TE, Kokame GT, Kaneko KN, Lian R, Lai JC, Wee R. Sensitivity And Specificity Of Detecting Polypoidal Choroidal Vasculopathy With En Face Optical Coherence Tomography And Optical Coherence Tomography Angiography. Retina. 2019 Jul;39(7):1343–52.
37. Saito M, Iida T, Nagayama D. Cross-Sectional And En Face Optical Coherence Tomographic Features Of Polypoidal Choroidal Vasculopathy. Retina. 2008 Mar;28(3):459–64.
38. Alasil T, Ferrara D, Adhi M, Brewer E, Kraus MF, Baumal CR, et al. En Face Imaging of the Choroid in Polypoidal Choroidal Vasculopathy Using Swept-Source Optical Coherence Tomography. American Journal of Ophthalmology. 2015 Apr;159(4):634-643.e2.
39. Srour M, Querques G, Semoun O, el Ameen A, Miere A, Sikorav A, et al. Optical coherence tomography angiography characteristics of polypoidal choroidal vasculopathy. British Journal of Ophthalmology. 2016 Nov;100(11):1489–93.
40. Cheung CMG, Yanagi Y, Mohla A, Lee SY, Mathur R, Chan CM, et al. Characterization And Differentiation Of Polypoidal Choroidal Vasculopathy Using Swept Source Optical Coherence Tomography Angiography. Retina. 2017 Aug;37(8):1464–74.
41. Huang YM, Hsieh MH, Li AF, Chen SJ. Sensitivity, Specificity, and Limitations of Optical Coherence Tomography Angiography in Diagnosis of Polypoidal Choroidal Vasculopathy. Journal of Ophthalmology. 2017;2017:1–7.
42. Palkar A, Khetan V. Polypoidal choroidal vasculopathy: An update on current management and review of literature. Taiwan Journal of Ophthalmology. 2019;9(2):72.
43. Chi YT, Yang CH, Cheng CK. Optical Coherence Tomography Angiography for Assessment of the 3-Dimensional Structures of Polypoidal Choroidal Vasculopathy. JAMA Ophthalmology. 2017 Dec 1;135(12):1310.
44. Bo Q, Yan Q, Shen M, Song M, Sun M, Yu Y, et al. Appearance of Polypoidal Lesions in Patients With Polypoidal Choroidal Vasculopathy Using Swept-Source Optical Coherence Tomographic Angiography. JAMA Ophthalmology. 2019 Jun 1;137(6):642.
45. Yang J, Zhang C, Wang E, Chen Y, Yu W. Utility of a public-available artificial intelligence in diagnosis of polypoidal choroidal vasculopathy. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2020 Jan 1;258(1):17–21.
46. Xu Z, Wang W, Yang J, Zhao J, Ding D, He F, et al. Automated diagnoses of age-related macular degeneration and polypoidal choroidal vasculopathy using bi-modal deep convolutional neural networks. British Journal of Ophthalmology. 2021 Apr;105(4):561–6.
47. Tsai YY, Lin WY, Chen SJ, Ruamviboonsuk P, King CH, Tsai CL. Diagnosis of Polypoidal Choroidal Vasculopathy From Fluorescein Angiography Using Deep Learning. Translational Vision Science & Technology. 2022 Feb 3;11(2):6.
48. Chou YB, Hsu CH, Chen WS, Chen SJ, Hwang DK, Huang YM, et al. Deep learning and ensemble stacking technique for differentiating polypoidal choroidal vasculopathy from neovascular age-related macular degeneration. Scientific Reports. 2021 Dec 30;11(1):7130.
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Published
2022-10-25
How to Cite
Ciputra, F. (2022). POLYPOIDAL CHOROIDAL VASCULOPATHY: CURRENT DIAGNOSIS IN THE ERA OF MULTIMODAL IMAGING . Jurnal Kedokteran, 11(3), 1033–1044. https://doi.org/10.29303/jku.v11i3.780
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