Polypoidal Choroidal Vasculopathy

Abstract

Polypoidal choroidal vasculopathy (PCV) is generally considered a variant of type 1 choroidal neovascularization, and the polyps are thought to originate from the vascular network. Commonly used diagnostic criteria for PCV are either the Japanese Study Group of PCV or the EVEREST Study. The prevalence of PCV is estimated to be 0.3–0.4% in the general East Asian populations, and its prevalence among neovascular age-related macular degeneration (nAMD) patients ranges from 22.3% to 61.6% in Asians. Risk factors include male sex, cigarette smoking, and high serum high-density lipoprotein cholesterol, and prevalence of diabetes is less in PCV compared to typical nAMD. Drusen are less common in eyes with PCV compared to those with typical nAMD, and pachychoroid is the main driver of the angiogenic process in PCV. PCV and typical nAMD may share common genetic components, yet each genetic locus has different association signals between PCV and typical nAMD. Emerging real-world data support the current evidence reporting the effectiveness of anti-vascular endothelial growth factor (VEGF) therapy and combination therapy for PCV. New non-invasive high-resolution imaging modalities, such as optical coherence tomography (OCT) and OCT angiography, have been used in epidemiological studies, further improving our understanding of PCV.