Long-term outcomes of polypoidal choroidal vasculopathy in comparison with typical exudative age-related macular degeneration

Roh, Hyeon Cheol; Kim, Sang Jin; Kang, Se Woong; Eun, Jun Soo; Choi, Kyung Jun

doi:10.1007/s00417-021-05190-4

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…In the PRO-CON study for AMD with nonexudative neovascularization, there was no difference in the conversion rate between the prophylactic anti-vascular endo-thelial growth factor injection group and the sham injection group. 25 However, because the disease properties of PCV are quite dissimilar to those of typical exudative AMD, [26][27][28][29][30] careful consideration is required for the extrapolation of results in the PRO-CON study to nonexudative PCV. The effects of extrafoveal photocoagulation or juxtafoveal photodynamic therapy on the polypoidal area manifesting sequentially increased RPE protrusions have not yet been substantiated.…”

Section: Discussionmentioning

confidence: 99%

Risk of Exudation in Eyes with Non-exudative Polypoidal Choroidal Vasculopathy

Son,

Kim,

Kang

et al. 2023

Retina

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Purpose: To investigate the characteristics and natural history of treatment-naïve non-exudative polypoidal choroidal vasculopathy (PCV) and to determine biomarkers predicting exudative conversion. Methods: Patients diagnosed with non-exudative PCV based on indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were included. Incidence of exudative conversion in non-exudative PCV patients and cumulative estimates for overall risk were assessed. ICGA and OCT imaging-based features were analyzed to identify risk factors for exudative conversion. Results: The study included 42 eyes of 40 patients with non-exudative PCV. The mean follow-up duration was 54.3 ± 35.5 months. Of the 42 eyes with non-exudative PCV, exudative conversion developed in 23 eyes (54.8%) after 42.2 ± 28.3 months (range, 8–103 months). Kaplan–Meier analysis showed that the exudation-free survival at 5 years after baseline was estimated to be 53.6%. Multivariate regression analysis showed that sequentially increased protrusion of retinal pigment epithelium in the polyp area was a significant risk factor for exudation in non-exudative PCV (odds ratio = 10.16, 95% CI:1.78 to 57.81, P = .01). Conclusions: Exudative conversion has been noted in nearly half of the non-exudative PCV cases in 5 years. The progressive protrusion of polypoidal lesions on OCT examination might be a significant biomarker for predicting the near-term onset of exudation.

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Section: Discussionmentioning

confidence: 99%

Risk of Exudation in Eyes with Non-exudative Polypoidal Choroidal Vasculopathy

Son,

Kim,

Kang

et al. 2023

Retina

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“…This impression was supported by a recent real-world study on 9-year follow-up of 319 eyes, of which half were nAMD and another half were PCV. PCV eyes showed better favorable treatment responses, compared with AMD (final logMAR BCVA 0.9±0.6 vs. 0.6±0.5; P <0.001), with longer maintenance of visual improvement and later onset of significant visual decline 110…”

Section: Updates On Treatment Of Pcvmentioning

confidence: 91%

“…PCV eyes showed better favorable treatment responses, compared with AMD (final logMAR BCVA 0.9 ± 0.6 vs. 0.6 ± 0.5; P < 0.001), with longer maintenance of visual improvement and later onset of significant visual decline. 110 A post-hoc analysis of data from the EVEREST II Study was conducted to evaluate the influence of demographic and imaging factors at baseline and month 3 on visual and ana-tomical outcomes at month 12. In general, younger age and baseline BCVA were significantly associated with better BCVA gains at month 12; whereas baseline smaller polypoidal lesion area was associated with better BCVA at month 12 for IVR monotherapy.…”

Section: General Characteristicsmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy: Updates on Risk Factors, Diagnosis, and Treatments

Ruamviboonsuk

Cheung

Chainakul

et al. 2023

Asia-Pacific Journal of Ophthalmology

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There have been recent advances in basic research and clinical studies in polypoidal choroidal vasculopathy (PCV). A recent, large-scale, population-based study found systemic factors, such as male gender and smoking, were associated with PCV, and a recent systematic review reported plasma C-reactive protein, a systemic biomarker, was associated with PCV. Growing evidence points to an association between pachydrusen, recently proposed extracellular deposits associated with the thick choroid, and the risk of development of PCV. Many recent studies on diagnosis of PCV have focused on applying criteria from noninvasive multimodal retinal imaging without requirement of indocyanine green angiography. There have been attempts to develop deep learning models, a recent subset of artificial intelligence, for detecting PCV from different types of retinal imaging modality. Some of these deep learning models were found to have high performance when they were trained and tested on color retinal images with corresponding images from optical coherence tomography. The treatment of PCV is either a combination therapy using verteporfin photodynamic therapy and anti-vascular endothelial growth factor (VEGF), or anti-VEGF monotherapy, often used with a treat-and-extend regimen. New anti-VEGF agents may provide more durable treatment with similar efficacy, compared with existing anti-VEGF agents. It is not known if they can induce greater closure of polypoidal lesions, in which case, combination therapy may still be a mainstay. Recent evidence supports long-term follow-up of patients with PCV after treatment for early detection of recurrence, particularly in patients with incomplete closure of polypoidal lesions.

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