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2015 ; 4
(5
): 782-821
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Polypoidal Choroidal Vasculopathy in Asians
#MMPMID26239448
Wong CW
; Wong TY
; Cheung CM
J Clin Med
2015[Apr]; 4
(5
): 782-821
PMID26239448
show ga
Age related macular degeneration (AMD) in Asians has been suggested to differ
from their Western counterparts in terms of epidemiology, pathogenesis, clinical
presentation and treatment. In particular, polypoidal choroidal vasculopathy
(PCV) appears to be the predominant subtype of exudative AMD in Asian
populations, in contrast to choroidal neovascularization secondary to AMD
(CNV-AMD) in Western populations. Epidemiological data on PCV has been largely
limited to hospital-based studies and there are currently no data on the
incidence of PCV. Similarities and differences in risk factor profile between PCV
and CNV-AMD point to some shared pathogenic mechanisms but also differential
underlying mechanisms leading to the development of each phenotype. Serum
biomarkers such as CRP, homocysteine and matrix metalloproteinases suggest
underlying inflammation, atherosclerosis and deranged extracellular matrix
metabolism as possible pathogenic mechanisms. In addition, recent advances in
genome sequencing have revealed differences in genetic determinants of each
subtype. While the standard of care for CNV-AMD is anti-vascular endothelial
growth factor (VEGF) therapy, photodynamic therapy (PDT) has been the mainstay of
treatment for PCV, although long-term visual prognosis remains unsatisfactory.
The optimal treatment for PCV requires further clarification, particularly with
different types of anti-VEGF agents and possible benefits of reduced fluence PDT.
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