Intravitreal Anti-Vascular Endothelial Growth Factor Treatment for Pachychoroid Neovasculopathy

Cho, Han Joo; Jung, Seong Heon; Cho, Suyeon; Han, Jae Ook; Park, Saemi; Kim, Jong Woo

doi:10.1089/jop.2018.0107

Cited by 28 publications

(20 citation statements)

References 24 publications

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“…It has been reported that persistent polypoidal lesions may pose a risk of massive submacular hemorrhage. 53 In clinic-based studies, several groups have used various combinations of OCT features and have reported high sensitivity and specificity for differentiating PCV from typical nAMD. Based on the presence of at least 3 of 4 OCT signs (multiple PEDs, sharp PED peak, PED notch, and rounded sub-RPE hyporeflective area), De Salvo et al 28 found the sensitivity and specificity to be more than 90%.…”

Section: Discussionmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy

et al. 2021

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To develop consensus terminology in the setting of polypoidal choroidal vasculopathy (PCV) and to develop and validate a set of diagnostic criteria not requiring indocyanine green angiography (ICGA) for differentiating PCV from typical neovascular age-related macular degeneration (nAMD) based on a combination of OCT and color fundus photography findings.Design: Evaluation of diagnostic test results.Participants: Panel of retina specialists. Methods: As part of the Asia-Pacific Ocular Imaging Society, an international group of experts surveyed and discussed the published literature regarding the current nomenclature and lesion components for PCV, and proposed an updated consensus nomenclature that reflects our latest understanding based on imaging and histologic reports. The workgroup evaluated a set of diagnostic features based on OCT images and color fundus photographs for PCV that may distinguish it from typical nAMD and assessed the performance of individual and combinations of these non-ICGA features, aiming to propose a new set of diagnostic criteria that does not require the use of ICGA. The final recommendation was validated in 80 eyes from 2 additional cohorts.Main Outcome Measures: Consensus nomenclature system for PCV lesion components and noneICGAbased criteria to differentiate PCV from typical nAMD.Results: The workgroup recommended the terms polypoidal lesion and branching neovascular network for the 2 key lesion components in PCV. For the diagnosis of PCV, the combination of 3 OCT-based major criteria (suberetinal pigment epithelium [RPE] ring-like lesion, en face OCT complex RPE elevation, and sharp-peaked PED) achieved an area under the receiver operating characteristic curve of 0.90. Validation of this new scheme in a separate subset 80 eyes achieved an accuracy of 82%.Conclusions: We propose updated terminology for PCV lesion components that better reflects the nature of these lesions and is based on international consensus. A set of practical diagnostic criteria applied easily to spectral-domain OCT results can be used for diagnosing PCV with high accuracy in clinical settings in which ICGA is not performed routinely.

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Section: Discussionmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy

et al. 2021

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“…All the eyes were classified as PNV, PCV/AT1, and typical nAMD after reviewing the medical records of the patients with nAMD. The definition of PNV was based on the latest reports 2 , 10 , 13 , 14 , since it is still evolving. PNV was diagnosed using the following criteria: (1) definite type 1 CNV on OCT and ancillary images, including FA/ICGA images; (2) no drusen in both eyes (no AMD, AREDS category; (3) presence of dilated choroidal vessels below the macular neovascularization; and (4) PPE or CSC characteristics including choroidal vascular hyperpermeability (CVH) on ICGA 15 , or a history of CSC.…”

Section: Methodsmentioning

confidence: 99%

“…Currently, PNV is treated with anti-vascular endothelial growth factor (VEGF) in the same way as nAMD without distinction because PNV harbors CNV 2 , 7 , 9 . Several investigations have reported the favorable outcome of anti-VEGF treatment for PNV 10 – 12 . However, to date, long-term evaluation of the treatment efficacy of anti-VEGF for PNV has not been sufficiently reported.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome of intravitreal anti-vascular endothelial growth factor treatment for pachychoroid neovasculopathy

Yoon

et al. 2021

Sci Rep

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To compare the long-term effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) treatment for pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy/aneurysmal type 1 neovascularization (PCV/AT1), and typical neovascular age-related macular degeneration (nAMD). Forty-one eyes with PNV, 68 eyes with PCV/AT1, and 56 eyes with typical nAMD were retrospectively included for analysis. All patients were treatment-naïve and received a three-monthly loading injection of anti-VEGF, followed by further injections, as required. The visual and anatomical outcomes after treatment were evaluated up to 36 months from baseline. No significant intergroup difference was found in terms of best-corrected visual acuity (BCVA) and changes in central foveal thickness at 12, 24, and 36 months after the baseline. In addition, no significant difference was found between the groups regarding the proportions of improved or worsened (increased or decreased more than 3-lines) visual acuity. However, the PNV group participants received significantly fewer anti-VEGF injections (11.7 ± 6.9) than those in the PCV/AT1 (12.4 ± 7.0; P = 0.031) and typical nAMD groups (13.2 ± 7.4; P = 0.016). The incidence of macular atrophy (MA) development was also significantly lower for the PNV (4/41 eyes, 9.8%) than the typical nAMD (15/56 eyes, 26.8%; P = 0.033) eyes. There was no significant difference between PNV, PCV/AT1, and typical nAMD regarding visual acuity improvement after anti-VEGF treatment over 36 months. However, the number of injections for PNV was significantly lower compared to that for PCV/AT1 and typical nAMD, and the incidence of MA development was significantly lower than in typical nAMD.

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“…ey found that PCN required significantly fewer injections than nAMD during a 2-year follow-up [10]. Furthermore, Cho et al [11] compared a 12-month clinical outcome between PCN and nAMD cases who were initially treated with three monthly injection followed by the PRN regimen. Although there was no significant intergroup difference in terms of visual acuity achievement, they suggested that the response to anti-VEGF treatment could be different between PCN and nAMD groups.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Clinical Features and Long-Term Outcomes of Pachychoroid Neovasculopathy and Type 1 Neovascular Age-Related Macular Degeneration

You

Kim

2020

Journal of Ophthalmology

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Purpose. To evaluate the clinical characteristics and long-term prognosis of pachychoroid neovasculopathy (PCN) when compared with type 1 neovascular age-related macular degeneration (nAMD). Methods. We retrospectively analyzed 30 and 60 patients whose eyes were diagnosed as treatment-naïve PCN or type 1 nAMD, respectively. All subjects were followed up for 5 years. Baseline angiographic characteristics and long-term clinical outcomes were compared between the two groups. Results. PCN group consisted of patients of younger age and represented more choroidal vascular hyperpermeability, polypoidal lesion, and history of central serous chorioretinopathy (CSC) at the time of diagnosis (all p < 0.01). During the 5-year follow-up period, individuals in the PCN group received significantly fewer injections and reported better visual acuity compared to individuals in the type 1 nAMD group. A progressive decrease in the subfoveal choroidal thickness was observed in the type 1 nAMD group, while the thick choroid was maintained in the PCN group during the 5-year follow-up period. Conclusions. PCN developed in younger patients with a higher propensity of forming polypoidal lesions and a history of CSC. Long-term outcomes revealed that PCN had a thicker choroid and better visual prognosis with fewer number of intravitreal injection than that of type 1 nAMD.

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Intravitreal Anti-Vascular Endothelial Growth Factor Treatment for Pachychoroid Neovasculopathy

Cited by 28 publications

References 24 publications

Polypoidal Choroidal Vasculopathy

Polypoidal Choroidal Vasculopathy

Long-term outcome of intravitreal anti-vascular endothelial growth factor treatment for pachychoroid neovasculopathy

Comparative Analysis of the Clinical Features and Long-Term Outcomes of Pachychoroid Neovasculopathy and Type 1 Neovascular Age-Related Macular Degeneration

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