Pachychoroid disease spectrum: review article

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 260; no. 3; pp. 723 - 735
• Main Authors: Mazzeo, Thiago José Muniz Machado, Leber, Henrique Monteiro, da Silva, Allan Gomes, Freire, Raimunda Cristina Mendonça, Barbosa, Gabriel Castilho Sandoval, Criado, Guilherme Garcia, Jacob, Gabriel Almeida Veiga, Machado, Cleide Guimarães, Gomes, André Marcelo Vieira
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2022; Springer Nature B.V
• Subjects: Aneurysm; Atrophy; Central Serous Chorioretinopathy - diagnosis; Choroid; Choroid Diseases - diagnosis; Differential diagnosis; Fluorescein Angiography - methods; Humans; Literature reviews; Medicine; Medicine & Public Health; Ophthalmology; Phenotypes; Retrospective Studies; Review Article; Tomography, Optical Coherence - methods; Vascular diseases; Vascularization; Polypoidal choroidal vasculopathy; Multimodal retinal imaging; Photodynamic therapy; Anti-VEGF therapy; Central serous chorioretinopathy; Pachychoroid
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-021-05450-3

Purpose The aim of this article is to do a comprehensive literature review about the current understandings of the pachychoroid disease spectrum, describing its multimodal imaging analysis, pathophysiology, differential diagnosis, and current types of management. Methods This comprehensive literature review was performed based on a search on the PubMed database, of relevant pachychoroid published papers according to our current knowledge. Discussion The pachychoroid disease spectrum, according to some authors, includes the following: pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy (PCV)/aneurysmal type 1 neovascularization (AT1), and more recently focal choroidal excavation (FCE) and peripapillary pachychoroid syndrome (PPS). Each one of these entities will be described and discussed in this article. Conclusion Significant advances in multimodal imaging have enabled a better understanding of the typical choroidal changes in pachychoroid disease spectrum. The clinical knowledge and managing options about this disease significantly increased in the last years. However, it is still unclear why some eyes with typical pachychoroid disease phenotype show no evidence of RPE damage and subretinal fluid (uncomplicated pachychoroid) while others present progressive tissue damage, neovascularization, and atrophy.