title: Polypoidal choroidal vasculopathy: evidence-based guidelines for clinical diagnosis and treatment.
abstract: BACKGROUND
  Polypoidal choroidal vasculopathy (PCV) is an exudative maculopathy affecting vision, with clinical features distinct from neovascular age-related macular degeneration. Currently, no evidence-based guidelines exist for its diagnosis and treatment.
  
  
  METHODS
  A panel of experts analyzed a systematic literature search on PCV together with results of the EVEREST trial, the only published randomized controlled clinical trial in PCV. At a subsequent Roundtable meeting, recommendations for the management of PCV were agreed based on this analysis and their own expert opinion.
  
  
  RESULTS
  Diagnosis of PCV should be based on early-phase nodular hyperfluorescence from choroidal vasculature visualized using indocyanine green angiography. Recommended initial treatment of juxtafoveal and subfoveal PCV is either indocyanine green angiography-guided verteporfin photodynamic therapy or verteporfin photodynamic therapy plus 3 × 0.5 mg ranibizumab intravitreal injections 1 month apart. If there is incomplete regression of polyps by indocyanine green angiography, eyes should be retreated with verteporfin photodynamic therapy monotherapy or verteporfin photodynamic therapy plus ranibizumab. If there is complete regression of polyps by indocyanine green angiography, but there is leakage on fluorescein angiography and other clinical or anatomical signs of disease activity, eyes should be retreated with ranibizumab.
  
  
  CONCLUSIONS
  Practical guidance on the clinical management of PCV is proposed based on expert evaluation of current evidence.
authors: Eye & Retina Surgeons, Camden Medical Centre, Singapore. ahckoh@yahoo.com
authors: Adrian H C
authors: AH
authors: Koh
authors: Lee-Jen
authors: LJ
authors: Chen
authors: Shih-Jen
authors: SJ
authors: Chen
authors: Youxin
authors: Y
authors: Chen
authors: Anantharam
authors: A
authors: Giridhar
authors: Tomohiro
authors: T
authors: Iida
authors: Hakyoung
authors: H
authors: Kim
authors: Timothy
authors: T
authors: Yuk Yau Lai
authors: Won Ki
authors: WK
authors: Lee
authors: Xiaoxin
authors: X
authors: Li
authors: Tock
authors: T
authors: Han Lim
authors: Paisan
authors: P
authors: Ruamviboonsuk
authors: Tarun
authors: T
authors: Sharma
authors: Shibo
authors: S
authors: Tang
authors: Mitsuko
authors: M
authors: Yuzawa
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D004396:Coloring Agents; D016208:Databases, Factual; D019317:Evidence-Based Medicine; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011127:Polyps / Q000175:diagnosis* / Q000188:drug therapy*; D011166:Porphyrins / Q000627:therapeutic use; D000069579:Ranibizumab; D000077362:Verteporfin
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green; D000069579:Ranibizumab