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

Yoon, Ji-Hyun; Yoon, Wontae; Na, Seung Kwan; Lee, Ji‐Hyun; Kim, Chul Gu; Kim, Jong Woo; Cho, Han Joo

doi:10.1038/s41598-021-91589-2

Cited by 10 publications

(4 citation statements)

References 31 publications

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“…Although this study did not deny the inclusion of eyes with polypoidal lesions in PNV, another study on PNV from South Korea excluded eyes with polypoidal lesions from PNV, based on their understanding that type 1 CNV with polypoidal lesions should be classified as PCV [ 73 ]. Later studies from Korea have also considered PNV without polypoidal lesions as PNV and PNV with polypoidal lesions as PCV [ 74 , 75 , 76 , 77 ]. In Europe, an Italian study group included eyes with polypoidal lesions in PNV [ 78 ], whereas study groups from Germany and Turkey excluded eyes with polypoidal lesions from PNV [ 79 , 80 , 81 , 82 , 83 ].…”

Section: Establishment Of the Pachychoroid Conceptmentioning

confidence: 99%

“…To date, only one group from South Korea compared PNV and nAMD by excluding eyes with polypoidal lesions from the studied cohorts ( Table 9 ). This group suggested no clear difference in fluid control and visual acuity change after anti-VEGF treatment for PNV and nAMD [ 72 , 77 ]. Other studies on PNV without polypoidal lesions have reported that PDT and anti-VEGF treatment were effective for PNV without polypoidal lesions [ 64 , 65 , 66 , 73 , 80 , 81 , 85 , 86 ].…”

Section: Treatment Response Of Pnvmentioning

confidence: 99%

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Relationship between Pachychoroid and Polypoidal Choroidal Vasculopathy

Yamashiro

Yanagi

Koizumi

et al. 2022

JCM

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Previous clinical studies have suggested that pachychoroid can induce macular neovascularization (MNV) to develop pachychoroid neovasculopathy (PNV) and that PNV can progress to polypoidal choroidal vasculopathy (PCV). Recent studies based on the pachychoroid concept are now gradually revealing the true nature of, at least some part of, PCV. However, previous studies on PNV and/or PCV have used different frameworks for the classification of PNV, PCV, and neovascular age-related macular degeneration (nAMD). These have hampered the rapid overhaul of the understanding of PCV. Some investigators have assumed that all PCV is pachychoroid-driven whereas other investigators have classified PCV into “pachychoroid PCV” and “non-pachychoroid PCV”. Furthermore, since there is no consensus as to whether PNV includes PCV, some studies have included PCV with PNV, while other studies have excluded PCV from PNV. To address these gaps, we summarize previous studies on PCV and pachychoroid. Even before the proposal of the pachychoroid concept, previous studies had suggested that PCV could be divided into two subtypes, of which one was characterized by pachychoroid features. Previous studies had also provided keys to understand relationship between PCV and PNV. We here recommend a refined conceptual framework for future studies on PNV, PCV, and nAMD. Considering the current inconsistent understanding of PCV, we should be cautious about using the term PCV until we understand the true nature of PCV.

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Section: Establishment Of the Pachychoroid Conceptmentioning

confidence: 99%

Section: Treatment Response Of Pnvmentioning

confidence: 99%

Relationship between Pachychoroid and Polypoidal Choroidal Vasculopathy

Yamashiro

Yanagi

Koizumi

et al. 2022

JCM

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“…In the present study, macular atrophy developed in some patients of each group with a comparable incidence. Yoon et al reported that 3-year incidence of macular atrophy was 9.8%, that was smaller than typical AMD [ 26 ]. The result of the present study showed similar incidence (7%).…”

Section: Discussionmentioning

confidence: 99%

Intravitreal anti-vascular endothelial growth factor and combined photodynamic therapy for pachychoroid neovasculopathy: long-term treatment outcomes

Tanaka,

Azuma,

Aoki

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose To examine the long-term visual outcomes after initial treatment with combined photodynamic therapy (PDT) or aflibercept treat-and-extend (TAE) monotherapy in patients with pachychoroid neovasculopathy (PNV). Methods Patients diagnosed with PNV, initially treated with PDT combined with anti-vascular endothelial growth factor (VEGF) or intravitreal aflibercept (IVA) monotherapy in the TAE protocol and followed up for at least 6 months, were included in the study. Medical records were retrospectively reviewed. Survival analysis was performed, in which deterioration in logMAR visual acuity by 0.1 or 0.3 is defined as “death.” The annual number of treatments was also analyzed. Sub-analysis was performed on 33 patients diagnosed with PNV without polypoidal lesions. Results This study included 46 patients (23 in the initial combined PDT group and 23 in the IVA TAE group). Mean age, sex, mean baseline logMAR visual acuity, or duration of observation (3.6 ± 3.2 years vs. 3.1 ± 1.9 years) in both groups were comparable. As for visual outcome, no significant differences were found in survival analysis based on worsening of 0.1 or 0.3 logMAR (3-year survival; 26% vs. 26%, 91% vs. 90%, respectively). Meanwhile, the additional number of anti-VEGF injections per year was significantly lower in the initial combined PDT group than in the IVA TAE group (1.0 ± 1.3 vs. 4.1 ± 1.5, p < 0.0001). No significant differences were found in the number of additional PDTs per year (0.07 ± 0.20 vs. 0.02 ± 0.09, p = 0.27). Similar results were found in a sub-analysis of 33 patients without polyps. Conclusion In the treatment of PNV, regardless of the presence of polyps, the long-term visual outcomes were similar between the initial combined PDT and IVA TAE monotherapy. However, the annual number of anti-VEGF injections was lower in the initial combined PDT group than in the aflibercept TAE group, whereas that of PDT was comparable.

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“…38 PNV requires a fewer number of injections than neovascular age-related macular degeneration, with longer treatmentfree period of up to 36 months. 39,40 PDT of various dosage and fluence is effective on improving visual acuity, central macular thickness, and choroidal thickness. 26,30 PDT enables fluid absorption in patients non-responsive to anti-VEGF.…”

Section: Pachychoroid Neovasculopathymentioning

confidence: 99%