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Polypoidal Choroidal Vasculopathy in Asians

Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751 Singapore, Singapore
Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, 169857 Singapore, Singapore
Author to whom correspondence should be addressed.
Academic Editors: Lindsay Farrer and Margaret DeAngelis
J. Clin. Med. 2015, 4(5), 782-821;
Received: 15 March 2015 / Accepted: 13 April 2015 / Published: 24 April 2015
(This article belongs to the Special Issue Age-Related Macular Disease)
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. View Full-Text
Keywords: polypoidal choroidal vasculopathy; Asians; epidemiology; risk factors; genetics; photodynamic therapy; anti vascular endothelial growth factor polypoidal choroidal vasculopathy; Asians; epidemiology; risk factors; genetics; photodynamic therapy; anti vascular endothelial growth factor
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Wong, C.W.; Wong, T.Y.; Cheung, C.M.G. Polypoidal Choroidal Vasculopathy in Asians. J. Clin. Med. 2015, 4, 782-821.

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