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《息肉样脉络膜血管病变管理指南更新:来自印度息肉样脉络膜血管病变专家组和印度玻璃体视网膜学会的建议》。

Updated guidelines for the management of polypoidal choroidal vasculopathy: Recommendations from the Indian Polypoidal Choroidal Vasculopathy Panel and the Vitreoretinal Society of India.

机构信息

Department of Clinical Research, Chaithanya Eye Hospital, Trivandrum, Kerala, India.

Vitreoretinal Society of India (VRSI) General Secretary, Vitreoretinal Society of India, Kochi, Kerala, India.

出版信息

Indian J Ophthalmol. 2022 Aug;70(8):3102-3111. doi: 10.4103/ijo.IJO_2985_21.

Abstract

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.

摘要

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。

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