Retina and Vitreous Department, Suel Abujamra Institute, São Paulo, Brazil.
Retina and Vitreous Department, University of São Paulo (USP), São Paulo, Brazil.
Graefes Arch Clin Exp Ophthalmol. 2022 Mar;260(3):723-735. doi: 10.1007/s00417-021-05450-3. Epub 2021 Oct 14.
The aim of this article is to do a comprehensive literature review about the current understandings of the pachychoroid disease spectrum, describing its multimodal imaging analysis, pathophysiology, differential diagnosis, and current types of management.
This comprehensive literature review was performed based on a search on the PubMed database, of relevant pachychoroid published papers according to our current knowledge.
The pachychoroid disease spectrum, according to some authors, includes the following: pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy (PCV)/aneurysmal type 1 neovascularization (AT1), and more recently focal choroidal excavation (FCE) and peripapillary pachychoroid syndrome (PPS). Each one of these entities will be described and discussed in this article.
Significant advances in multimodal imaging have enabled a better understanding of the typical choroidal changes in pachychoroid disease spectrum. The clinical knowledge and managing options about this disease significantly increased in the last years. However, it is still unclear why some eyes with typical pachychoroid disease phenotype show no evidence of RPE damage and subretinal fluid (uncomplicated pachychoroid) while others present progressive tissue damage, neovascularization, and atrophy.
本文旨在对当前对肥厚脉络膜疾病谱的认识进行全面的文献回顾，描述其多模态影像学分析、病理生理学、鉴别诊断和当前的治疗类型。
根据我们目前的知识，我们在 PubMed 数据库上进行了全面的文献检索，以搜索与肥厚脉络膜相关的已发表论文。
根据一些作者的观点，肥厚脉络膜疾病谱包括以下几种：肥厚脉络膜色素上皮病变（PPE）、中心性浆液性脉络膜视网膜病变（CSC）、肥厚脉络膜新生血管病变（PNV）、息肉状脉络膜血管病变（PCV）/动脉瘤样 1 型新生血管（AT1），以及最近的局限性脉络膜凹陷（FCE）和视盘周围肥厚脉络膜综合征（PPS）。本文将对这些实体中的每一个进行描述和讨论。
多模态成像技术的显著进步使我们能够更好地理解肥厚脉络膜疾病谱中的典型脉络膜变化。近年来，关于这种疾病的临床知识和治疗选择有了显著增加。然而，目前仍不清楚为什么一些具有典型肥厚脉络膜疾病表型的眼睛没有 RPE 损伤和视网膜下液（单纯性肥厚脉络膜）的证据，而另一些眼睛则表现出进行性组织损伤、新生血管形成和萎缩。
