72 - Pachychoroid disease and its association with polypoidal choroidal vasculopathy

Abstract

Pachychoroid is a relatively new concept describing a phenotype characterized by attenuation of the inner choroid overlying dilated choroidal veins, choroidal hyperpermeability, and progressive retinal pigment epithelium dysfunction and neovascularization. The emphasis in defining pachychoroid-related disorders has shifted away from simply an abnormally thick choroid (“pachychoroid”) toward a detailed morphologic definition of a pathologic state (“pachychoroid disease”) with functional implications. Applications of new and multimodality imaging is essential in evaluating pachychoroid disease spectrum. Several clinical manifestations have been described to reside within the pachychoroid disease spectrum, including central serous chorioretinopathy, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, and peripapillary pachychoroid syndrome. Furthermore, polypoidal choroidal vasculopathy with a pachychoroid background is believed to develop as aneurysmal dilations from pachychoroid neovasculopathy. Hence we propose a new term, “aneurysmal pachychoroid neovasculopathy,” to reflect the link with the underlying choroidal condition. Diseases residing within the pachychoroid spectrum are believed to represent different manifestations of a common pathogenic process. In eyes with neovascularization, there may be similarities in genetics and other risk factor profiles with age-related macular degeneration.