Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Ophthalmology, School of Medicine, National Taiwan University, Taipei, Taiwan; Department of Ophthalmology, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
J Formos Med Assoc. 2020 Feb;119(2):569-576. doi: 10.1016/j.jfma.2019.04.012. Epub 2019 May 7.
Polypoidal choroidal vasculopathy (PCV) is a prevalent retinal disease predominantly occurs in Asians that shares some similarities seen in neovascular age-related macular degeneration. Recent large multicenter clinical trials on intravitreal anti-vascular endothelial growth factor (VEGF) agents and photodynamic therapy (PDT) have shed lights on the management of PCV. The Taiwan National Health Insurance had granted limited anti-VEGF agents and PDT for patients with PCV after the approval of required data submission, especially fundus angiography, optical coherence tomography, and visual acuity. In order to best utilize these limited resources for the patients, an expert meeting was held to provide updated Taiwan consensus recommendations for the management of PCV, including initial therapy selection, assessment of treatment response, re-treatment/rescue treatment, and determination of treatment extension/follow-up schedule. An algorithm for treatment allocation under both initial and re-treatment setting was proposed. Further mechanistic and clinical studies are required to investigate the prognostic factors and optimal treatment protocols that will improve healthcare quality and reduce burden of disease and treatment for patients with PCV.
息肉样脉络膜血管病变(PCV)是一种常见的视网膜疾病,主要发生在亚洲人群,与新生血管性年龄相关性黄斑变性有一些相似之处。最近关于玻璃体内抗血管内皮生长因子(VEGF)药物和光动力疗法(PDT)的大型多中心临床试验为 PCV 的治疗提供了一些启示。在提交所需数据获得批准后,台湾全民健康保险为 PCV 患者提供了有限的抗 VEGF 药物和 PDT,特别是眼底血管造影、光学相干断层扫描和视力检查。为了让患者能够充分利用这些有限的资源,专家会议提供了 PCV 管理的最新台湾共识建议,包括初始治疗选择、治疗反应评估、再次治疗/抢救治疗以及治疗延伸/随访计划的确定。提出了初始和再次治疗设置下的治疗分配算法。需要进一步的机制和临床研究来探讨预后因素和最佳治疗方案,以提高医疗质量,减轻患者的疾病和治疗负担。