Polypoidal Choroidal Vasculopathy

Purpose of Review: The aim of this review is to summarize developments in the treatment of active polypoidal choroidal vasculopathy (PCV). PCV is associated with a poor visual prognosis as a consequence of the condition’s hallmark polypoidal dilatation and a branching network resulting in recurrent hemorrhages and serous leakage. Recent Findings: Recent research has provided new insights into the pathogenesis of PCV. While still considered a subtype of age-related macular degeneration, suggestions that PCV belongs to a spectrum of conditions that present with a pachychoroid are increasingly well accepted. Treatment remains challenging. Combination therapy (photodynamic therapy (PDT) and intravitreal anti-vascular endothelial growth factor (VEGF)) is associated with higher polyp closure rate, but polyp closure rate has not been correlated with superior visual outcomes. Current data points to non-inferiority of anti-VEGF alone versus combined with PDT when final vision acuity is the study outcome. Summary: PCV remains a clinical challenge. Classification and treatment of the condition continue to evolve. Combination therapy may not be superior to anti-VEGF treatment alone in terms of visual acuity outcome; however, data on long-term recurrence should be compared in formulating preferred treatment plans.