PMID- 34262165
OWN - NLM
STAT- MEDLINE
DCOM- 20220415
LR  - 20230204
IS  - 1476-5454 (Electronic)
IS  - 0950-222X (Print)
IS  - 0950-222X (Linking)
VI  - 36
IP  - 2
DP  - 2022 Feb
TI  - Evolving treatment paradigms for PCV.
PG  - 257-265
LID - 10.1038/s41433-021-01688-7 [doi]
AB  - Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular AMD (nAMD) 
      that accounts for a significant proportion of nAMD cases worldwide, and 
      particularly in Asia. Contemporary PCV treatment strategies have closely followed 
      those used in typical nAMD, though there are significant gaps in knowledge on PCV 
      management and it remains unclear if these strategies are appropriate. Current 
      clinical trial data suggest intravitreal anti-vascular endothelial growth factor 
      (VEGF) therapy alone or in combination with photodynamic therapy is effective in 
      managing haemorrhage and exudation in PCV, although the optimal treatment 
      interval, including as-needed and treat-and-extend approaches, is unclear. Newer 
      imaging modalities, including OCT angiography and high-resolution spectral domain 
      OCT have enabled characterisation of unique PCV biomarkers that may provide 
      guidance on how and when treatment and re-treatment should be initiated. 
      Treatment burden for PCV is a major focus of future therapeutic research and 
      several newly developed anti-VEGF agents, including brolucizumab, faricimab, and 
      new modes of drug delivery like the port delivery system, offer hope for 
      dramatically reduced treatment burden for PCV patients. Beyond anti-VEGF therapy, 
      recent developments in our understanding of PCV pathophysiology, in particular 
      the role of choroidal anatomy and lipid mediators in PCV pathogenesis, offer new 
      treatment avenues that may become clinically relevant in the future. This article 
      explores the current management of PCV and more recent approaches to PCV 
      treatment based on an improved understanding of this unique disease process.
CI  - (c) 2021. The Author(s).
FAU - Fenner, Beau J
AU  - Fenner BJ
AD  - Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, 
      Singapore.
AD  - Duke-NUS Graduate Medical School, National University of Singapore, Singapore, 
      Singapore.
FAU - Cheung, Chui Ming Gemmy
AU  - Cheung CMG
AD  - Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, 
      Singapore.
AD  - Duke-NUS Graduate Medical School, National University of Singapore, Singapore, 
      Singapore.
FAU - Sim, Shaun S
AU  - Sim SS
AUID- ORCID: 0000-0001-8940-4842
AD  - Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, 
      Singapore.
FAU - Lee, Won Ki
AU  - Lee WK
AD  - Nune Eye Hospital, Seoul, South Korea.
FAU - Staurenghi, Giovanni
AU  - Staurenghi G
AD  - Eye Clinic, Department of Biomedical and Clinical Sciences "Luigi Sacco", 
      University of Milan, Milan, Italy.
FAU - Lai, Timothy Y Y
AU  - Lai TYY
AUID- ORCID: 0000-0002-7832-6428
AD  - Department of Ophthalmology and Visual Sciences, The Chinese University of Hong 
      Kong, Hong Kong Eye Hospital, Hong Kong, China.
FAU - Ruamviboonsuk, Paisan
AU  - Ruamviboonsuk P
AD  - Department of Ophthalmology, Rajavithi Hospital, Bangkok, Thailand.
FAU - Kokame, Gregg
AU  - Kokame G
AD  - Division of Ophthalmology, Department of Surgery, University of Hawaii School of 
      Medicine, Honolulu, HI, USA.
FAU - Yanagi, Yasuo
AU  - Yanagi Y
AD  - Department of Ophthalmology and Microtechnology, Yokohama City University, 
      Yokohama, Japan.
FAU - Teo, Kelvin Y C
AU  - Teo KYC
AUID- ORCID: 0000-0002-7458-7081
AD  - Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, 
      Singapore. kelvin.teo.y.c@singhealth.com.sg.
AD  - Duke-NUS Graduate Medical School, National University of Singapore, Singapore, 
      Singapore. kelvin.teo.y.c@singhealth.com.sg.
AD  - University of Sydney, Sydney, Australia. kelvin.teo.y.c@singhealth.com.sg.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210714
PL  - England
TA  - Eye (Lond)
JT  - Eye (London, England)
JID - 8703986
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Vascular Endothelial Growth Factor A)
SB  - IM
MH  - Angiogenesis Inhibitors/therapeutic use
MH  - Choroid/blood supply
MH  - *Choroidal Neovascularization/drug therapy
MH  - Fluorescein Angiography
MH  - Humans
MH  - *Polyps
MH  - Tomography, Optical Coherence
MH  - Vascular Endothelial Growth Factor A/therapeutic use
MH  - Visual Acuity
MH  - *Wet Macular Degeneration/drug therapy
PMC - PMC8807588
COIS- The authors declare no competing interests.
EDAT- 2021/07/16 06:00
MHDA- 2022/04/16 06:00
PMCR- 2021/07/14
CRDT- 2021/07/15 06:12
PHST- 2021/05/31 00:00 [received]
PHST- 2021/07/01 00:00 [accepted]
PHST- 2021/06/28 00:00 [revised]
PHST- 2021/07/16 06:00 [pubmed]
PHST- 2022/04/16 06:00 [medline]
PHST- 2021/07/15 06:12 [entrez]
PHST- 2021/07/14 00:00 [pmc-release]
AID - 10.1038/s41433-021-01688-7 [pii]
AID - 1688 [pii]
AID - 10.1038/s41433-021-01688-7 [doi]
PST - ppublish
SO  - Eye (Lond). 2022 Feb;36(2):257-265. doi: 10.1038/s41433-021-01688-7. Epub 2021 
      Jul 14.