Department of Clinical Research, Chaithanya Eye Hospital, Trivandrum, Kerala, India.
Vitreoretinal Society of India (VRSI) General Secretary, Vitreoretinal Society of India, Kochi, Kerala, India.
Indian J Ophthalmol. 2022 Aug;70(8):3102-3111. doi: 10.4103/ijo.IJO_2985_21.
In Asians, polypoidal choroidal vasculopathy (PCV) is becoming more widely recognized as a significant cause of exudative maculopathy. The previous set of Indian guidelines on the management of PCV were published in 2018, with a literature search updated up to November 2015. As the treatment of PCV evolves, retinal physicians must constantly modify their current practice. The current guidelines are based on the most up-to-date information on PCV and are an update to the previous set of guidelines. These guidelines were developed by a panel of Indian retinal experts under the aegis of the Vitreoretinal Society of India (VRSI), based on a comprehensive search and assessment of literature up to September 2021. The final guidelines i) provide the updated nomenclature in PCV; ii) discusses the newer diagnostic imaging features of PCV, especially in the absence of indocyanine green angiography (ICGA); and iii) recommends the best possible therapeutic approach in the management of PCV, including the choice of anti-vascular endothelial growth factor (anti-VEGF) agents, treatment regimen, and the role of switching between the anti-VEGF agents. In the face of non-availability of photodynamic therapy (PDT) in India, we constructed practical recommendations on anti-VEGF monotherapy in PCV. The current updated recommendations would provide a broader framework to the treating retinal physician for the diagnosis and management of PCV for optimal therapeutic outcomes.
在亚洲人中,息肉样脉络膜血管病变(PCV)越来越被认为是渗出性黄斑病变的一个重要原因。2018 年发布了关于 PCV 管理的前一套印度指南,文献检索更新至 2015 年 11 月。随着 PCV 治疗的发展,视网膜医生必须不断修改他们目前的治疗方法。本指南基于 PCV 的最新信息,是对上一组指南的更新。这些指南是由印度视网膜专家小组在印度玻璃体视网膜学会(VRSI)的支持下制定的,根据截至 2021 年 9 月的全面文献搜索和评估。最终指南:i)提供 PCV 中更新的命名法;ii)讨论 PCV 的更新诊断成像特征,特别是在没有吲哚青绿血管造影(ICGA)的情况下;iii)建议在 PCV 管理中尽可能最好的治疗方法,包括选择抗血管内皮生长因子(抗-VEGF)药物、治疗方案以及在抗-VEGF 药物之间转换的作用。鉴于印度无法提供光动力疗法(PDT),我们在 PCV 的抗 VEGF 单药治疗方面制定了实用建议。目前的更新建议将为治疗视网膜医生提供一个更广泛的框架,以诊断和管理 PCV,以获得最佳治疗效果。