Pachychoroid Neovasculopathy Within The Spectrum of Pachychoroid Disease

Volume 1 - Issue 3

Di Carlo E^1,2* and Augustin AJ¹

Received: April 25, 2018;   Published: April 27, 2018

DOI: 10.32474/TOOAJ.2018.01.000111

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Abstract

Pachychoroid neovasculopathy is a relatively new retinal disease, characterized by the presence of Type 1 choroidal neovascularization associated with signs of increased choroidal thickening and hyperpermeability. The latter features are distinctive of pachychoroid spectrum disease, which also includes pachychoroid pigment epitheliopathy, central serous chorioretinopathy and polypoidal choroidal vasculopathy. These pathologies share common features, such as choroidal vascular disfunction, abnormalities of the retinal pigment epithelium without showing typical characteristics of age related macular degeneration and, occasionally, choroidal new vessels. Many recent works have tried to analyze the main aspects of pachychoroid neovasculopathy with the aim to better understand the natural course and the proper management of the disease. Multimodal imaging modality, with the recent advent of the optical coherence tomography angiography, plays a fundamental role to help the physicians to distinguish choroidal neovascularization in pachychoroid disease from neovascular age related macular degeneration. In this review, we summarize the latest updates in the pathogenesis, clinical features, and advances in imaging multimodalities in order to delineate a clearer description of the pachychoroid neovasculopathy. Finally, we propose recommendation guidelines for the diagnosis and management of this relatively new clinical entity. Nevertheless, larger studies and clinical trials are needed to achieve standardized diagnostic criteria and treatment modalities.

Keywords: Pachychoroid neovasculopathy; Pachychoroid disease; Neovascular age related macular degeneration; Neovascularization; Anti-VEGF

Abbreviation: EDI: Enhanced Depth Imaging; SSOCT: Swept Source Optical Coherence Tomography; CSC: Central Serous Chorioretinopathy; ICGA: Indo Cyanine Green Angiography; PEDs: pigment epithelial detachments; PPE: Pachychoroid Pigment Epitheliopathy; CNV: Choroidal Neo Vascularization; PCV: Polypoidal Choroidal Vasculopathy; PVN: Pachychoroid Neovasculopathy; BM: Bruch’s Membrane; OCTA: Optical Coherence Tomography Angiography; FAF: Fundus Auto Fluorescence; Anti-VEGF: Anti- Vascular Endothelial Growth Factors.

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