Q 1. What are the different names of polypoidal choroidal vasculopathy (PCV)?
a. Posterior uveal bleeding syndrome
b. Multiple recurrent retinal pigment epithelial detachment
c. Polypoidal choroidal neovascularisation
d. All the above
Q 2. Central serous chorioretinopathy as a feature of PCV belongs to which sub clinical classification group?
a. Group 1
b. Group 2
c. Group 3
d. Group 4
Q 3. In the EVEREST trial for PCV, the study groups included all except ?
a. Verteprophin Photodynamic therapy
b. Ranibizumab
c. Combined
d. None of the above
Q 4. What are the complications of Photo Dynamic therapy(PDT)?
a. Post-PDT hemorrhage
b. Massive supra-choroidal hemorrhage
c. RPE tears and microrips at the margin of the Pigment epithelial detachment
d. All the above
Q 5. Frequency of laser used in PDT is ___nm
a. 514
b. 532
c. 689
d. 810
Answers
- d. All the above
Various names have been used to describe this disease: idiopathic PCV, posterior uveal bleeding syndrome, multiple recurrent retinal pigment epithelial detachment (PED) in black women, has been known for almost 2 decades. and polypoidal choroidal neovascularization (CNV).
Reference – Chan WM, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, et al. Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology 2004;111:1576-1584. (https://pubmed.ncbi.nlm.nih.gov/15288991/)
2. b. Group 2
Clinical Subgroup Classification of PCV
Group 1 (subclinical group): angiographic polyps alone in ICG angiography with no leakage or hemorrhage in clinical examination, on ICG or on FAs (asymptomatic)
Group 2 (exudative group): presence of serous neurosensory retinal detachment, serous PED, lipid deposition, or hard exudates as a circinate ring or subretinal patch (central serous chorioretinopathy–like PCV)
Group 3 (hemorrhagic group): presence of streaky or localized hemorrhage in the subretinal or sub-RPE layers (CNV-like PCV). The total area of hemorrhage should be >2 Macular Photocoagulation Study disc areas
Group 4 (massive hemorrhagic group): presence of a large subretinal or sub-RPE hemorrhage with 2-MPS disc areas in the macular region
Reference – Chan WM, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, et al. Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology 2004;111:1576-1584. (https://pubmed.ncbi.nlm.nih.gov/15288991/)
3. d. None of the above
EVEREST Study: Efficacy and Safety of Verteporfin Photodynamic Therapy in Combination With Ranibizumab or Alone Versus Ranibizumab Monotherapy in Patients With Symptomatic Macular Polypoidal Choroidal Vasculopathy
Reference – Koh A, Lee WK, Chen LJ, et al. EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina. 2012;32(8):1453‐1464. (https://pubmed.ncbi.nlm.nih.gov/22426346/)
4. d. All the above
Complications of PDT for PCV include post-PDT hemorrhage, massive supra-choroidal hemorrhage, RPE tears and microrips at the margin of the PED
Reference – Wong RL, Lai TY. Polypoidal choroidal vasculopathy: an update on therapeutic approaches. J Ophthalmic Vis Res. 2013;8(4):359‐371.(https://pubmed.ncbi.nlm.nih.gov/24653824/)
5. c. 689nm
Argon green laser – 514nm
Frequency double Nd-YAG laser – 532nm
PDT – 689nm
Trans pupillary thermo therapy – near infra red diode 810nm
Reference – Abdulrahman Faisal AlBloushi, MD, Marwan A. Abouammoh, MD Lasers (surgery) American Academy of Ophthalmology, EyeWiki. January 5, 2020.(https://eyewiki.aao.org/Lasers_(surgery)