The recognition of polypoidal choroidal vasculopathy based on the pachychoroid spectrum disease_Chinese Journal of Ocular Fundus Diseases

Authors：

Chen Chunli ^1,2 , Ren Xinjun ¹ , Liu Juping ¹ ,  Li XiaoRong ¹

1. Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, College of Optometry and Ophthalmology, Tianjin 300384, China;
2. Department of Ophthalmology, Shengli Oilfield Central Hospital, Dongying 300070, China;

Corresponding author：

Li XiaoRong, Email: xiaorli@163.com

Keywords：

Choroid diseases; Central serous chorioretinopathy; Choroidal neovascularization; Review

DOI：

10.3760/cma.j.issn.1005-1015.2019.03.023

Video：

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The fundus appearance of polypoidal choroidal vasculopathy (PCV) often demonstrates orange-red nodular lesions. ICGA reveals terminal dilation of the polyps with or without branching vascular networks. Currently, pachychoroid spectrum disease is a series of conditions included choroidal vasodilatation and increased permeability due to choroidal ischemia, choroidal thickening, retinal pigment epitheliopathy, and secondary pigment epithelial detachment, choroidal neovascularization and polyps included uncomplicated pachychoroid, pachychoroid pigment epitheliopathy, pachychoroid neovascularization, central serous chorioretinopathy, and PCV. These entities have the similar characteristics and prognosis, suggesting that they have the similar pathology. The recognition of PCV based on the pachychoroid spectrum disease can provide new ideas for the prevention and intervention of PCV.

Citation： Chen Chunli, Ren Xinjun, Liu Juping, Li XiaoRong. The recognition of polypoidal choroidal vasculopathy based on the pachychoroid spectrum disease. Chinese Journal of Ocular Fundus Diseases, 2019, 35(3): 306-311. doi: 10.3760/cma.j.issn.1005-1015.2019.03.023 Copy

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2.	Ma L, Li Z, Liu K, et al. Association of genetic variants with polypoidal choroidal vasculopathy: a systematic review and updated meta-analysis[J]. Ophthalmology, 2015, 122(9): 1854-1865. DOI: 10.1016/j.ophtha.2015.05.012.
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1. Tanaka K, Nakayama T, Mori R, et al. Associations of complement factor B and complement component 2 genotypes with subtypes of polypoidal choroidal vasculopathy[J]. BMC Ophthalmol, 2014, 14: 83. DOI: 10.1186/1471-2415-14-83.
2. Ma L, Li Z, Liu K, et al. Association of genetic variants with polypoidal choroidal vasculopathy: a systematic review and updated meta-analysis[J]. Ophthalmology, 2015, 122(9): 1854-1865. DOI: 10.1016/j.ophtha.2015.05.012.
3. Nakashizuka H, Mitsumata M, Okisaka S, et al. Clinicopathologic findings in polypoidal choroidal vasculopathy[J]. Invest Ophthalmol Vis Sci, 2008, 49(11): 4729-4737. DOI: 10.1167/iovs.08-2134.
4. Tong JP, Chan WM, Liu DT, et al. Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization[J]. Am J Ophthalmol, 2006, 141(3): 456-462. DOI: 10.1016/j.ajo.2005.10.012.
5. Chung SE, Kang SW, Lee JH, et al. Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration[J]. Ophthalmology, 2011, 118(5): 840-845. DOI: 10.1016/j.ophtha.2010.09.012.
6. Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy[J]. Retina, 2013, 33(8): 1659-1672. DOI: 10.1097/IAE.0b013e3182953df4.
7. Pang CE, Freund KB. Pachychoroid neovasculopathy[J]. Retina, 2015, 35(1): 1-9. DOI: 10.1097/IAE.0000000000000331.
8. Ersoz MG, Karacorlu M, Arf S, et al. Outer nuclear layer thinning in pachychoroid pigment epitheliopathy[J]. Retina, 2018, 38(5): 957-961. DOI: 10.1097/IAE.0000000000001655.
9. Ueta T, Obata R, Inoue Y, et al. Background comparison of typical age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients[J]. Ophthalmology, 2009, 116(12): 2400-2406. DOI: 10.1016/j.ophtha.2009.06.013.
10. Kondo N, Honda S, Kuno S, et al. Coding variant I62V in the complement factor H gene is strongly associated with polypoidal choroidal vasculopathy[J]. Ophthalmology, 2009, 116(2): 304-310. DOI: 10.1016/j.ophtha.2008.11.011.
11. Lee KY, Vithana EN, Mathur R, et al. Association analysis of CFH, C2, BF, and HTRA1 gene polymorphisms in Chinese patients with polypoidal choroidal vasculopathy[J]. Invest Ophthalmol Vis Sci, 2008, 49(6): 2613-2619. DOI: 10.1167/iovs.07-0860.
12. Huang L, Zhang H, Cheng CY, et al. A missense variant in FGD6 confers increased risk of polypoidal choroidal vasculopathy[J]. Nature Genetics, 2016, 48(6): 640-647. DOI: 10.1038/ng.3546.
13. Anidjar S, Salzmann JL, Gentric D, et al. Elastase-induced experimental aneurysms in rats[J]. Circulation, 1990, 82(3): 973-981. DOI: 10.1161/01.CIR.82.3.973.
14. Kondo N, Honda S, Ishibashi K, et al. Elastin gene polymorphisms in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy[J]. Invest Ophthalmol Vis Sci, 2008, 49(3): 1101-1105. DOI: 10.1167/iovs.07-1145.
15. Raffetto JD, Khalil RA. Matrix metalloproteinases and their inhibitors in vascular remodeling and vascular disease[J]. Biochem Pharmacol, 2008, 75(2): 346-359. DOI: 10.1016/j.bcp.2007.07.004.
16. Zeng R, Wen F, Zhang X, et al. Serum levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 elevated in polypoidal choroidal vasculopathy but not in age-related macular degeneration[J]. Mol Vis, 2013, 19: 729-736.
17. Meng Q, Huang L, Sun Y, et al. Effect of high-density lipoprotein metabolic pathway gene variations and risk factors on neovascular age-related macular degeneration and polypoidal choroidal vasculopathy in China[J/OL]. PLoS One, 2015, 10(12): 143924[2015-12-01]. https://doi.org/10.1371/journal.pone.0143924. DOI: 10.1371/journal.pone.0143924.
18. Cheng HC, Liu JH, Lee SM, et al. Hyperhomocysteinemia in patients with polypoidal choroidal vasculopathy: a case control study[J/OL]. PLoS One, 2014, 9(10): 110818[2014-10-22]. https://doi.org/10.1371/journal.pone.0110818. DOI: 10.1371/journal.pone.0110818.
19. Ross RD, Gitter KA, Cohen G, et al. Idiopathic polypoidal choroidal vasculopathy associated with retinal arterial macroaneurysm and hypertensive retinopathy[J]. Retina, 1996, 16(2): 105-111. DOI: 10.1097/00006982-199616020-00003.
20. Rishi P, Rishi E, Mathur G, et al. Ocular perfusion pressure and choroidal thickness in eyes with polypoidal choroidal vasculopathy, wet-age-related macular degeneration, and normals[J]. Eye (Lond), 2013, 27(9): 1038-1043. DOI: 10.1038/eye.2013.106.
21. 谈颂, 刘鸣, 张世洪, 等. 腔隙性脑梗死血管危险因素与小血管病理类型的研究[J]. 中国临床康复, 2005, 9(13): 104-106. DOI: 10.3321/j.issn.1673-8225.2005.13.069.Tan S, Liu M, Zhang SH, et al. Vascualr risk factor and vasculopathy in lacunar cerebral infarction[J]. Chinese Journal of Clinical Rehabilitation, 2005, 9(13): 104-106. DOI: 10.3321/j.issn.1673-8225.2005.13.069.
22. Matet A, Daruich A, Zola M, et al. Risk factors for recurrences of central serous chorioretinopathy[J]. Retina, 2018, 38(7): 1403-1414. DOI: 10.1097/IAE.0000000000001729.
23. Yu PK, Tan PE, Cringle SJ, et al. Phenotypic heterogeneity in the endothelium of the human vortex vein system[J]. Exp Eye Res, 2013, 115(10): 144-152. DOI: 10.1016/j.exer.2013.07.006.
24. Tan PE, Yu PK, Cringle SJ, et al. Regional heterogeneity of endothelial cells in the porcine vortex vein system[J]. Microvasc Res, 2013, 89: 70-79. DOI: 10.1016/j.mvr.2013.06.004.
25. Wallman J, Wildsoet C, Xu A, et al. Moving the retina: choroidal modulation of refractive state[J]. Vision Res, 1995, 35(1): 37-50. DOI: 10.1016/0042-6989(94)E0049-Q.
26. Rada J, Palmer L. Choroidal regulation of scleral glycosaminoglycan synthesis during recovery from induced myopia[J]. Invest Ophthalmol Vis Sci, 2007, 48(7): 2957-2966. DOI: 10.1167/iovs.06-1051.
27. Manayath GJ, Shah VS, Saravanan VR, et al. Polypoidal choroidal vasculopathy associated with central serous chorioretinopathy: pachychoroid spectrum of diseases[J]. Retina, 2018, 38(6): 1195-1204. DOI: 10.1097/IAE.0000000000001665.
28. Tian Y, Wildsoet CF. Diurnal fluctuations and developmental changes in ocular dimensions and optical aberrations in young chicks[J]. Invest Ophthalmol Vis Sci, 2006, 47(9): 4168-4178. DOI: 10.1167/iovs.05-1211.
29. Garg A, Oll M, Yzer S, et al. Reticular pseudodrusen in early age-related macular degeneration are associated with choroi- dal thinning[J]. Invest Ophthalmol Vis Sci, 2013, 54(10): 7075-7081. DOI: 10.1167/iovs.13-12474.
30. Coscas F, Puche N, Coscas G, et al. Comparison of macular choroidal thickness in adult onset foveomacular vitelliform dystrophy and age-related macular degeneration[J]. Invest Ophthalmol Vis Sci, 2014, 55(1): 64-69. DOI: 10.1167/iovs.13-12931.
31. Ramrattan RS, van der Schaft TL, Mooy CM, et al. Morphometric analysis of Bruch's membrane, the choriocapillaris, and the choroid in aging[J]. Invest Oophthalmol Vis Sci, 1994, 35(6): 2857-2864.
32. Goldenberg D, Moisseiev E, Goldstein M, et al. Enhanced depth imaging optical coherence tomography: choroidal thickness and correlations with age, refractive error, and axial length[J]. Ophthalmic Surg Lasers Imaging, 2012, 43(4): 296-301. DOI: 10.3928/15428877-20120426-02.
33. Dansingani KK, Balaratnasingam C, Naysan J, et al. En face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography[J]. Retina, 2016, 36(3): 499-516. DOI: 10.1097/IAE.0000000000000742.
34. Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy[J]. Retina, 2011, 31(8): 1603-1608. DOI: 10.1097/IAE.0b013e31820f4b39.
35. Ersoz MG, Karacorlu M, Arf S, et al. Pachychoroid pigment epitheliopathy in fellow eyes of patients with unilateral central serous chorioretinopathy[J]. Br J Ophthalmol, 2018, 102(4): 473-478. DOI: 10.1136/bjophthalmol-2017-310724.
36. Kim YT, Kang SW, Bai KH. Choroidal thickness in both eyes of patients with unilaterally active central serous chorioretinopathy[J]. Eye, 2011, 25(2): 1635-1640. DOI: 10.1038/eye.2011.258.
37. Nathaniel Roybal C, Sledz E, Elshatory Y, et al. Dysfunctional autonomic regulation of the choroid in central serous chorioretinopathy[J]. Retina, 2018, 38(6): 1205-1210. DOI: 10.1097/IAE.0000000000001677.
38. Brandl C, Helbig H, Gamulescu MA. Choroidal thickness measurements during central serous chorioretinopathy treatment[J]. Int Ophthalmol, 2014, 34(1): 7-13. DOI: 10.1007/s10792-013-9774-y.
39. Sato T, Kishi S, Watanabe G, et al. Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy[J]. Retina, 2007, 27(5): 589-594. DOI: 10.1097/01.iae.0000249386.63482.05.
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Chinese Journal of Ocular Fundus Diseases

The recognition of polypoidal choroidal vasculopathy based on the pachychoroid spectrum disease

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