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Pachychoroid spectrum disorders
Retina & Vitreous
Key Points
- •The pachychoroid spectrum (PPE → CSC → PNV → FCE → PCV) is unified by thick choroid ≥300 μm, pachyvessels in the Haller layer, and thinned choriocapillaris - fundamentally distinct from AMD
- •Absence of drusen is the key feature distinguishing pachychoroid neovasculopathy (PNV) and PCV from wet AMD - this distinction has critical treatment implications
- •EDI-OCT is the first-line investigation; ICGA is the gold standard for diagnosing PCV (branching vascular network + polyps); OCTA detects subclinical type 1 CNV in PNV
- •PCV treatment: combination PDT + anti-VEGF is superior to anti-VEGF monotherapy for polyp closure - EVEREST II: 69% vs 35% at 12 months
- •Corticosteroids are contraindicated across the entire pachychoroid spectrum - they worsen choroidal hyperpermeability and promote progression from PPE to CSC to PNV
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations