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Pachychoroid disease: a new perspective on exudative maculopathy

  • Forefront Review
  • Organizer: Akitaka Tsujikawa, MD
  • Published:
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Abstract

Background

Pachychoroid, or the structural and functional abnormalities of the choroid, is one of the most important causes of exudative maculopathies. The purpose of this article is to review the current definitions of pachychoroid and their potential consequences.

Summary of findings

Most publications are from Asian countries. Although no consensus diagnosis has been reached, pachychoroid is defined by thickened choroid and choroidal vascular hyperpermeability, pachyvessels with inner choroidal attenuation; it is closely linked to pachydrusen. Although some studies suggest choroidal congestion may play a role in its pathogenesis, the exact causes of this condition are still unknown. Pachychoroid is associated with exudative maculopathies including central serous chorioretinopathy, pachychoroid neovasculopathy and polypoidal choroidal vasculopathy (PCV). It is widely accepted that macular neovascular membranes may develop secondary to pachychoroid. Recent clinical observations illustrate the importance of pachychoroid in the etiology of macular neovascularization including neovascular age-related macular degeneration (nAMD).

Conclusion

Pachychoroid is an important cause of exudative maculopathies. Both drusen and pachychoroid are increasingly recognized as important causes of macular neovascularization, and eyes formally categorized as typical nAMD or PCV can be further sub-categorized based on the presence or absence of pachychoroid and drusen. There is a need to develop a consensus definition, which will greatly enhance our understanding of pachychoroid and facilitate the development of individual interventions in pachychoroid diseases.

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  1. Department of Ophthalmology, Asahikawa Medical University, Hokkaido, Japan

    Yasuo Yanagi

  2. Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore

    Yasuo Yanagi

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Organizer: Akitaka Tsujikawa, MD

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Yanagi, Y. Pachychoroid disease: a new perspective on exudative maculopathy. Jpn J Ophthalmol 64, 323–337 (2020). https://doi.org/10.1007/s10384-020-00740-5

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