Optical Coherence Tomography Angiography for Choroidal and Vitreoretinal Disorders – Part 2

Polypoidal Choroidal Vasculopathy and Pachychoroid Neovasculopathy Represent Different Manifestations of the Same Disease

Author(s): Erick A. Quiroz-Gonzalez*, Miguel A. Quiroz-Reyes and Zixuan Shao

Pp: 94-115 (22)

DOI: 10.2174/9789815196658123010008

* (Excluding Mailing and Handling)

Abstract

The pachychoroid spectrum has various clinical manifestations. There are three major characteristics, all of which have an unknown etiology and controversial pathogenesis: pachychoroid, presence of pachyvessels at the external choroid, and inner choroidal attenuation. This study describes a patient with clinical and multimodal manifestations in the pachychoroid spectrum, in which different clinical variants are presented in both eyes simultaneously. Specifically, the patient had an acute visual loss and massive hemorrhagic maculopathy in the right eye, and a chronic decrease in visual acuity and metamorphopsia in the left eye accompanied by pigmentary changes and subretinal fluid at the geometric center of the fovea. The patient underwent a complete ophthalmological examination and multimodal imaging and was diagnosed with polypoidal choroidal vasculopathy (PCV) and pachychoroid neovasculopathy (PNV); two different manifestations of the same disease spectrum occur simultaneously.

Owing to the active nature of the disease, the patient received three doses of intravitreal antiangiogenic agents in each eye. Many different degenerative etiologies have been considered, such as pathological choroidal neovascularization due to age-related macular degeneration (AMD) and pachychoroid spectrum. Evaluation of the choroid vasculature using swept-source optical coherent tomography (SS-OCT) and OCT angiography (OCT-A) revealed the origin of the disease to be idiopathic. PCV and PNV are considered to represent a single end-stage of the pachychoroid spectrum with different manifestations; the former presents with aneurysmatic characteristics, whereas the latter lacks this anomaly. 

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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59235952 and j.to_ip >=59235952 )) and ((j.from_date <= 1739834990 and j.to_date >= 1739834990 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 21352) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59235952 and j.to_ip >=59235952 )) and ((j.from_date <= 1739834990 and j.to_date >= 1739834990 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 21352) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59235952 and j.to_ip >=59235952 )) and ((j.from_date <= 1739834990 and j.to_date >= 1739834990 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 21352)
      530μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 3649 and `b`.`banner_from_date` <= 1739834990 and `b`.`banner_to_date` >= 1739834990 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.04msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3649
      • 3: 1739834990
      • 4: 1739834990
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='86439966145800067f47eb222247ac22'
      190μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        2jSSSkIvPoY7JqBhNocfHxFftf3dMhKs8LwZo6oW
        uc_cart_id
        86439966145800067f47eb222247ac22
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/21352" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/21352
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
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        response_headers
        0 of 0
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        session_attributes
        0 of 0
        array:5 [ "_token" => "2jSSSkIvPoY7JqBhNocfHxFftf3dMhKs8LwZo6oW" "uc_cart_id" => "86439966145800067f47eb222247ac22" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/21352" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-17 23:29:50GET/chapter/21352112192