Polypoidal choroidal vasculopathy: Angiographic characterization of the network vascular elements and a new treatment paradigm

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dc.contributor.author Costa, R. A.
dc.contributor.author Navajas, E. V.
dc.contributor.author Farah, M. E.
dc.contributor.author Calucci, D.
dc.contributor.author Cardillo, J. A.
dc.contributor.author Scott, I. U.
dc.date.accessioned 2016-01-24T12:38:02Z
dc.date.available 2016-01-24T12:38:02Z
dc.date.issued 2005-09-01
dc.identifier http://dx.doi.org/10.1016/j.preteyeres.2005.01.001
dc.identifier.citation Progress in Retinal and Eye Research. Oxford: Pergamon-Elsevier B.V., v. 24, n. 5, p. 560-586, 2005.
dc.identifier.issn 1350-9462
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/28451
dc.description.abstract Macular exudative manifestations secondary to choroidal neovascular lesions remain the leading cause of definitive visual impairment and legal blindness in the elderly. During the past decade, advances in ophthalmic imaging systems have enabled the recognition of presumed new distinct choroidal neovascular lesions that share some unique clinical and angiographic peculiarities as well as better comprehension of the pathophysiologic mechanisms related to such entities.Amongst presumed newer exudative maculopathies, polypoidal choroidal vasculopathy, which has been described as a distinct choroidal abnormality characterized by inner choroidal vascular network of vessels ending in polyp-like structures only identified on indocyanine green angiography and mostly affecting African-American and Asian descendents, has gained special interest from the ophthalmic community particularly because of its growing recognition among patients with clinical appearance of neovascular agerelated macular degeneration. Thus far, however, the exact nature of the vascular structure of the polypoidal choroidal vasculopathy lesion remains unclear and data from recent studies have conflicted with the initial concept of a benign exudative maculopathy with long-term preservation of good vision. All together, such factors make difficult the establishment of an appropriate treatment, if any, for the entity.Herein, by using a modified technique of conventional indocyanine green angiography, we demonstrate new information about the morphologic characteristics, and to some extent the blood flow dynamics perfusion, of the polypoidal choroidal vasculopathy lesion. Our results suggest that the PCV lesion should be considered a variety of choroidal neovascularization rather than a distinct clinical entity, characterized by one single large neovascular complex presenting well-defined arterial neovascular vessels arising from one major ingrowth site and draining vessels that present aneurysm-like dilations corresponding to the polyp-like structures typically described for the entity. Finally, the visual acuity and angiographic findings observed after selective ingrowth site photothrombosis corroborate the existence of one major ingrowth site for the PCV neovascular complex and point toward a new treatment paradigm for this variety of choroidal neovascularization. (c) 2005 Elsevier B.V. All rights reserved. en
dc.format.extent 560-586
dc.language.iso eng
dc.publisher Elsevier B.V.
dc.relation.ispartof Progress in Retinal and Eye Research
dc.rights Acesso restrito
dc.title Polypoidal choroidal vasculopathy: Angiographic characterization of the network vascular elements and a new treatment paradigm en
dc.type Artigo
dc.rights.license http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.contributor.institution Hosp Olhos Araraquara
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Miami Univ
dc.description.affiliation Hosp Olhos Araraquara, Retina Diagnost & Treatment Div, BR-14801350 Araraquara, SP, Brazil
dc.description.affiliation Fed Univ São Paulo, São Paulo, SP, Brazil
dc.description.affiliation Miami Univ, Sch Med, Bascom Palmer Eye Inst, Dept Ophthalmol, Miami, FL USA
dc.description.affiliationUnifesp Fed Univ São Paulo, São Paulo, SP, Brazil
dc.identifier.doi 10.1016/j.preteyeres.2005.01.001
dc.description.source Web of Science
dc.identifier.wos WOS:000231005400002

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