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Year : 2018  |  Volume : 66  |  Issue : 7  |  Page : 896-908

Polypoidal choroidal vasculopathy: Pearls in diagnosis and management

1 Department of Vitreoretina, Giridhar Eye Institute, Kochi, Kerala, India
2 Department of Vitreoretinal Services, Sri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
3 Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India
4 Department of Vitreoretina, Aditya Jyot Eye Hospital Pvt. Ltd., Mumbai, Maharashtra, India
5 Retina-Vitreous Service, Aravind Eye Hospital, Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
6 Department of Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
7 Department of Vitreoretina, B. B. Eye Foundation, Kolkata, West Bengal, India
8 Bankers Retina Clinic and Laser Centre, Ahmedabad, Gujarat, India
9 Shroff Eye Center, New Delhi, India

Correspondence Address:
Giridhar Anantharaman
Giridhar Eye Institute, Ponneth Temple Road, Kadavanthra, Kochi - 682 020, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1136_17

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Polypoidal choroidal vasculopathy (PCV) is increasingly recognized as an important cause of exudative maculopathy in Asians as against Wet age-related macular degeneration in Caucasians. A panel of retinal experts methodically evaluated pertinent updated literature on PCV with thorough PubMed/MEDLINE search. Based on this, the panel agreed upon and proposed the current consensus recommendations in the diagnosis (clinical and imaging), management and follow-up schedule of PCV. Diagnosis of PCV should be based on the gold standard indocyanine green angiography which demonstrates early nodular hyperfluorescence signifying the polyp with additional features such as abnormal vascular network (AVN). Optical coherence tomography is an excellent adjuvant for diagnosing PCV, monitoring disease activity, and decision-making regarding the treatment. Current treatment modalities for PCV include photodynamic therapy, anti-vascular endothelial growth factor agents, and thermal laser. Choice of specific treatment modality and prognosis depends on multiple factors such as the location and size of PCV lesion, presence or absence of polyp with residual AVN, amount of submacular hemorrhage, presence or absence of leakage on fundus fluorescein angiography, visual acuity, and so on. Current recommendations would be invaluable for the treating physician in diagnosing PCV and in formulating the best possible individualized treatment strategy for optimal outcomes in PCV management.

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