Zhao Jinzhi, Chandrasekaran Priya R, Cheong Kai Xiong, Wong Mark, Teo Kelvin
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 168751, Singapore.
Tianjin Medical University Eye Hospital, Tianjin 300392, China.
Diagnostics (Basel). 2023 May 9;13(10):1680. doi: 10.3390/diagnostics13101680.
Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration (nAMD) that is characterized by a branching neovascular network and polypoidal lesions. It is important to differentiate PCV from typical nAMD as there are differences in treatment response between subtypes. Indocyanine green angiography (ICGA) is the gold standard for diagnosing PCV; however, ICGA is an invasive detection method and impractical for extensive use for regular long-term monitoring. In addition, access to ICGA may be limited in some settings. The purpose of this review is to summarize the utilization of multimodal imaging modalities (color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), and fundus autofluorescence (FAF)) in differentiating PCV from typical nAMD and predicting disease activity and prognosis. In particular, OCT shows tremendous potential in diagnosing PCV. Characteristics such as subretinal pigment epithelium (RPE) ring-like lesion, en face OCT-complex RPE elevation, and sharp-peaked pigment epithelial detachment provide high sensitivity and specificity for differentiating PCV from nAMD. With the use of more practical, non-ICGA imaging modalities, the diagnosis of PCV can be more easily made and treatment tailored as necessary for optimal outcomes.
息肉状脉络膜血管病变（PCV）是新生血管性年龄相关性黄斑变性（nAMD）的一种亚型，其特征为分支状新生血管网络和息肉样病变。将PCV与典型的nAMD区分开来很重要，因为不同亚型的治疗反应存在差异。吲哚菁绿血管造影（ICGA）是诊断PCV的金标准；然而，ICGA是一种侵入性检测方法，不适合广泛用于常规长期监测。此外，在某些情况下，可能无法进行ICGA检查。本综述的目的是总结多模态成像模式（彩色眼底照相、光学相干断层扫描（OCT）、OCT血管造影（OCTA）和眼底自发荧光（FAF））在区分PCV与典型nAMD以及预测疾病活动和预后方面的应用。特别是，OCT在诊断PCV方面显示出巨大潜力。视网膜色素上皮（RPE）环状病变、OCT正面复杂RPE隆起和尖峰状色素上皮脱离等特征在区分PCV与nAMD方面具有高敏感性和特异性。通过使用更实用的非ICGA成像模式，可以更轻松地诊断PCV，并根据需要定制治疗方案以实现最佳结果。
