The pachychoroid spectrum is a group of clinical entities that share a common characteristic: a thickened choroid.
Experts in this field shared their knowledge in diagnosing and managing this condition on Day 3 of the EURETINA 2021 Virtual Congress.
Different pathologies and characteristics Dr. Rosa Dolz-Marco from the Oftalvist Clinic, Spain, described the different pathologies that fall under the pachychoroid spectrum.
“Pigmentary changes in pachychoroid spectrum is called pachychoroid pigment epitheliopathy,
and it is usually asymptomatic unless it progress-es into another form in the spectrum,” shared
Dr. Dolz-Marco. “Pachychoroid pigment epitheliopathy is characterized ลาวสามัคคี
by the absence of subretinal fluid (acute or The Pachychoroid Spectrum A closer look at the latest diagnosis
and therapeutic options resolved), drusenoid retinal pigment epithelium (RPE) le-sions, and RPE thickening.”
It is typical to have the absence of leaking areas and choroidal hyperpermeability. “In central serous choroidopathy (CSC),
the classic form in the pachychoroid spectrum, we may have visual function impairment, neurosensory detachment, and retinal pigment epithelium changes,” she added.
In pachychoroid neovasculopathy (PNV), there is a typical shallow irregular RPE elevation
and we can clearly see the tangled network of vessels on the optical coherence tomography angiography (OCTA).
“Fluorescein angiography (FA) will show late leakage of an undetermined origin, while the indocyanine green angiography (ICGA) will reveal a late staining plaque,”
Dr. Dolz-Marco explained. She noted that a special type of neovascularization in the pachychoroid spectrum is the aneurysmal type 1 neovascularization (formerly known as polypoidal choroidal vasculopathy,
[PCV]), which presents with late leakage in FA, as well as branching vascular network with terminal aneurysmal dilatations in ICGA.
“Last but not least is the peripapillary pachychoroid syndrome (PPS), which unifies all the features of
and happens especially around the optic nerve. Its maximal thickness is around the optic nerve instead of temporally,” she said.
Photodynamic therapy in CSC and PPS Photodynamic therapy (PDT) involves the use of light-sensitive medicine and a light source to destroy abnormal
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