AAO Presentation: PCV The Most Important Subtype of Exudative or Wet Macular Degeneration

Dr. Gregg Kokame, medical director of the Hawaii Macula and Retina Institute, was the featured speaker on the importance of recognizing polypoidal choroidal vasculopathy (PCV) as the most important subtype of exudative or wet macular degeneration at one of the largest retina specialist meetings in the world – the Retina Subspecialty Day of the American Academy of Ophthalmology (AAO), which was held in Chicago on Friday, October 14, 2016.  There were approximately 4000 retina specialists in attendance, and the lecture was given in the same session with some of the most recognized leaders in retina in the United States.  For example, Dr. Daniel Martin, Chairman of the Cole Eye Institute of the Cleveland Clinic, spoke just before Dr. Kokame on the 5 year results of the National Eye Institute sponsored CATT trial on treatment for wet macular degeneration.  Just prior to Dr. Martin, Dr. Carl Regillo, Director of Retina at the Wills Eye Hospital in Philadelphia, spoke about the best ways to optimize treatment for wet macular degeneration.

Dr. Kokame emphasized that PCV is the most important subtype of wet macular degeneration, and the diagnosis is under-recognized in many parts of the world, but especially in the USA.  The diagnosis requires more than just a clinical exam, fluorescein angiogram and optical coherence tomography (OCT) map, which is what is utilized by the great majority of clinicians.  It requires indocyanine green angiography (ICGA) as the best diagnostic modality, and en face OCT analysis as a good more widely available alternative.

The importance of recognizing PCV is that there may be better alternatives to the usual treatment, which is the injection into the eye of an antiangiogenic drug on a schedule that often starts out monthly, but requires long term continued treatment at intervals from 5 to 10 weeks. The EVEREST II study was presented by Dr. Adrian Koh earlier at this meeting, which is a multi-centered prospective clinical trial from many countries in Asia, which showed better vision results with photodynamic therapy combined with antiangiogenic drug injections, than with antiangiogenic drug injection monotherapy.  This important new result requires that retina specialists identify PCV in order to provide the best care, as we have been doing here in Hawaii for many years.

Dr. Kokame was interviewed by the American Academy of Ophthalmology as a featured talk from Retina Subspecialty Day to be put on the AAO website.  Dr. Kokame also ran an advisory board teaching thought leaders throughout the USA on the importance of diagnosing PCV and managing it according to the most up to date information.  Dr. Kokame also taught a course for the AAO on PCV with the most published researchers in the world, including faculty from Hong Kong, Singapore, Korea and Japan.  This course is now in its 7th year after being evaluated every year for its teaching content and its educational benefit to the audience.



Left to right: Won Ki Lee, MD, Seoul Korea, Fumi Gomi MD, Osaka, Japan, Timothy Lai MD, Hong Kong, Gregg T. Kokame MD MMM, Honolulu, Hawaii, Adrian Koh MD, Singapore, Japan