Polypoidal choroidal vasculopathy

Abstract

The article presents literature review devoted to the issue of polypoidal choroidal vasculopathy. The studies of Russian and foreign researchers were reviewed. Epidemiological and clinical characteristics of polypoidal choroidal vasculopathy, diagnostic features and modern treatment methods, the results of clinical studies are presented. Polypoidal choroidal vasculopathy is a subtype of neoascular AMD with specific characteristics including predisposition of certain races, clinical features, serosanguineous complications of different severity, tendency to relapsing course of neovascularization and development of secondary serosanguineous exfoliation. It was registered most frequently in patients aged 50 to 65 years. Prevalence among Caucasians is 4 to 9.8%, and among Asians — 23.9 to 54.7%. Diagnosis of polypoidal choroidal vasculopathy requires the use of fluorescent angiography, indocyanine green angiography and optical coherence tomography. Polyps regression accordng to angiography is considered one of the aims of initial therapy of active polypoidal choroidal vasculopathy. According to Expert group of polypoidal choroidal vasculopathy, while using laser photocoagulation and photodynamic therapy, affecting both polyps and vasculature is required. As a result of the analysis of population studies, the results of treatment with laser coagulation, photodynamic therapy (independently and in combination with angiogenesis inhibitors) and monotherapy with angiogenesis inhibitors were demonstrated. Regardless of the achieved results of polypoidal choroidal vasculopathy diagnosis, the treatment issues require further investigation. Additional studies are required to evaluate long-term correlation between initial polyp regression, relapses, response central retinal vein occlusion, 9 of them had non-ischemic type and 10 had ischemic type of central retinal vein occlusion. 41 patients had branch retinal vein occlusion, 23 of them had non-ischemic type and 18 had ischemic type of occlusion. Patients underwent fluorescein angiography and optical coherence tomography fundus imaging. Before intravitreal injection of ranibizumab, the level of endothelin-1 in the blood serum was determined. Analysis was performed in patients’ subgroups depending on the localization of occlusion, type of occlusion, disease relapse, presence of optic disc swelling. Results . Differences in the systemic level of endothelin-1, depending on the localization of occlusion, presence of ischemic type and relapse, the disease was not detected (p ≥0.05). With the development of optic disc swelling, a statistically significant increase in the level of endothelin-1 was noted in peripheral blood: 38.73 fmol/ml in patients with