Thursday 27 September 2018

Pachychoroid Neovasculopathy Within The Spectrum of Pachychoroid Disease (TOOAJ)-Lupine Publishers

Pachychoroid neovasculopathy is a relatively new retinal disease, characterized by the presence of Type 1 choroidal neovascularization associated with signs of increased choroidal thickening and hyperpermeability. The latter features are distinctive of pachychoroid spectrum disease, which also includes pachychoroid pigment epitheliopathy, central serous chorioretinopathy and polypoidal choroidal vasculopathy. These pathologies share common features, such as choroidal vascular disfunction, abnormalities of the retinal pigment epithelium without showing typical characteristics of age related macular degeneration and, occasionally, choroidal new vessels. Many recent works have tried to analyze the main aspects of pachychoroid neovasculopathy with the aim to better understand the natural course and the proper management of the disease. Multimodal imaging modality, with the recent advent of the optical coherence tomography angiography, plays a fundamental role to help the physicians to distinguish choroidal neovascularization in pachychoroid disease from neovascular age related macular degeneration. In this review, we summarize the latest updates in the pathogenesis, clinical features, and advances in imaging multimodalities in order to delineate a clearer description of the pachychoroid neovasculopathy. Finally, we propose recommendation guidelines for the diagnosis and management of this relatively new clinical entity. Nevertheless, larger studies and clinical trials are needed to achieve standardized diagnostic criteria and treatment modalities.

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