OSLI Retina

October 2018

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748 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina ■ C L I N I C A L S C I E N C E ■ Characteristics of Polypoidal Choroidal Vasculopathy in OCT Angiography in Latin American Patients Juan D. Arias, MD; Andrea T. Hoyos, MD; M. Margarita Parra, MD; Álvaro J. Gutierrez, MD; Ronald M. Sanchez-Avila, MD, MSc, MBA BACKGROUND AND OBJECTIVES: To describe the imaging characteristics of polypoidal choroidal vasculopathy (PCV) in optical coherence tomogra- phy angiography (OCTA) and demonstrate its use as diagnostic method for this pathology in a Latin American population. PATIENTS AND METHODS: A case series. RESULTS: Fourteen eyes were evaluated. At base- line, the most frequent morphology was the "oval" type (76.9%), obtaining a reduction of 53.8% af- ter treatment. The intrinsic finding of the polyps was hyporeflective content prior to treatment (80.8%), which reduced after treatment (7.7%) (P = .016). CONCLUSIONS: OCTA is a useful imaging tool for detecting findings that can guide the diagnosis of PCV without contrast medium. Likewise, it pro- vides signs that can suggest the behavior of the le- sion prior to and after treatment, enriching the un- derstanding of the pathology and therefore aiming to an efficient therapy. To the best of the authors' knowledge, this is the first study in a Latin Ameri- can population. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:748-756.] INTRODUCTION Polypoidal choroidal vasculopathy (PCV) was elucidated in 1982 by Yanuzzi. 1,2 It is characterized by polypoidal dilations and neovascular choroidal networks. 2 Some authors believe that it is a variant of type 1 neovascularization, whereas others pro- pose that PCV is a different entity with alterations of choroidal vessels. 3 This statement is supported by the fact that risk factors, natural history, and re- sponse to treatment differ from those found in other types of choroidal neovascularization (CNV). The pathophysiology of PCV is related to an im- pairment of the inner choroidal circulation. 3-6 How- ever, vascular endothelial growth factor (VEGF) levels have shown discrepancy from different au- thors, 7,8 which is the reason why the role of VEGF in the pathogenesis and treatment is discussed. Therapeutic approaches to PCV include laser photocoagulation, photodynamic therapy (PDT), anti-VEGF agents, and combined treatments. Al- though antiangiogenic therapy could reduce fluid from PCV, it seems to be ineffective in diminishing its choroidal vascular changes. 9 Indocyanine green angiography (ICGA)-guided verteporfin PDT with or without anti-VEGF agents has been the standard preferred treatment, according to different stud- ies. 10 With technological advances over the years and improvement in image resolution, there have been achievements in the understanding of PVC and its pathophysiology. From Fundación Oftalmológica de Santander, Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia (JDA); FOSCAL Internacional, Floridablanca, Colombia (JDA, MMP); FOSCAL Internacional, Autonomous University of Bucaramanga, Floridablanca, Colombia (ATH, AJG); and Fundación de Investig- ación Oftalmológica, Instituto Universitario Fernández-Vega, Universidad de Oviedo, España (RMSA). Originally submitted December 28, 2017. Revision received August 5, 2018. Accepted for publication September 9, 2018. The authors report no relevant financial disclosures. Address correspondence to M. Margarita Parra, MD. Fundación Oftalmológica de Santander, Clínica Carlos Ardila lulle (FOSCAL), Floridablanca, Colombia 181004; email: mariamargaritaparrac@gmail.com. doi: 10.3928/23258160-20181002-02

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