Structural and Vascular Changes of the Choroid in Polypoidal Choroidal Vasculopathy after Intravitreal Anti-VEGF Therapy

Montorio, Daniela; Giordano, M; Concilio, Marina; Cennamo, Gilda

doi:10.1159/000521071

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…Of the risk factors for good first-dose anatomical response to anti-VEGF therapy in non-pachy-PCV patients, higher CMT reflects retinal edema, morphological abnormalities in the PED indicate the activeness of the PL, and a high percentage of IRF possibly indicates that anti-VEGF drugs promote the alleviation of macular edema. Previous studies showed that other OCT features, such as PED height [20], SFCT [21,22], and continuous RPE [23], are potential risk factors for the anti-VEGF response to PCV, which was partially consistent with our study. During follow-up of patients, CMT showed a significant decrease from baseline at all periods of follow-up (V1-V6) in the good first-dose anatomical response group, whereas the poor first-dose anatomical response group showed significant improvements at only a few periods.…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

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Evaluation of the First-Dose Anti-VEGF Anatomical Response in Polypoidal Choroidal Vasculopathy Patients: Correlation with the Third-Dose Response and Risk Factor Analysis

Wang,

Zhang,

Yang

et al. 2023

Ophthalmic Res

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Introduction: To investigate whether first-dose efficacy can predict third-dose anatomical response and analyze the risk factors for first-dose response of polypoidal choroidal vasculopathy (PCV) patients. Methods: We retrospectively reviewed patients’ medical records from 27-centers of China PCV Research Alliance. PCV patients treated with intravitreal injections of Conbercept based on the 3+ pro re nata (PRN) regimen (three initial monthly injections, followed by injections as needed) with complete 3-month injection data were included. Response correlations, risk factor associations, changes in central macular thickness (CMT) or best-corrected visual acuity (BCVA), and number of injections in the first year of follow-up were evaluated separately in the pachy-PCV and non-pachy-PCV phenotypes. Results: 165 eligible patients were included. There was a significant correlation between first-dose and third-dose anatomical response in pachy-PCV or non-pachy-PCV patients (rs=0.611, p<0.001; rs=0.638, p<0.001). Multivariate analysis revealed associations of good first-dose anatomical response in pachy-PCV patients with baseline CMT with a predicted area under the curve (AUC) of 0.847, while a good response in non-pachy-PCV patients was associated with baseline BCVA, baseline CMT, pigment epithelial detachment (PED) height, higher proportion of intraretinal fluid (IRF), and lower PED minimum diameter with a predicted AUC of 0.940. CMT in the good first-dose response group was significantly decreased from baseline at all first-year follow-up visits in both groups (p<0.001), and mean BCVA was improved in the good vs. poor first-dose anatomical response group (5.4 vs. 1.6 ETDRS letters in pachy-PCV, 10.6 vs. 7.4 letters in non-pachy-PCV) after the third injection. No significant difference was observed in the number of injections in the first year of follow-up between different response groups. Conclusion: In PCV patients receiving IVC, the first- and third-dose response are significantly correlated, and different factors influence the first-dose response in different subtypes of PCV.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Evaluation of the First-Dose Anti-VEGF Anatomical Response in Polypoidal Choroidal Vasculopathy Patients: Correlation with the Third-Dose Response and Risk Factor Analysis

Wang,

Zhang,

Yang

et al. 2023

Ophthalmic Res

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“…Previous authors have speculated that baseline choroidal thickness may be an important predictor for final vision outcomes. [ 3 , 51 , 52 ] Although Chang and Cheng proposed a sub-foveal choroidal thickness (SFCT) threshold of 267.5 µm for anti-VEGF treatment efficacy, [ 4 ] the clinical utility of SFCT thresholds is controversial. [ 53 ] Patients with PCV may also exhibit significant variability in choroidal thickness, [ 3 , 54 ] making threshold applications challenging for clinical diagnosis and treatment selection.…”

Section: Resultsmentioning

confidence: 99%

Pachychoroid Spectrum Disorders: An Updated Review

Brown

Mohan

Chhablani

2023

JOVR

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Pachychoroid disease spectrum is a recent term that has been associated with an increasing number of phenotypes. This review discusses updated findings for each of the typical pachychoroid entities (central serous chorioretinopathy, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, peripapillary pachychoroid syndrome, and focal choroidal excavation), as well as two relatively new additions (peripapillary pachychoroid neovasculopathy and peripheral exudative hemorrhagic chorioretinopathy). Here, we discuss the potential pathogenic mechanisms for these diseases and relevant imaging updates. Finally, we argue for a consistent classification scheme for these entities.

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Advances in multi-modal non-invasive imaging techniques in the diagnosis and treatment of polypoidal choroidal vasculopathy

Wang¹,

Gu²,

Chen³

2023

Front. Med.

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Polypoidal choroidal vasculopathy (PCV) is a disease characterized by subretinal pigment epithelium (RPE) orange-red polypoidal lesions and abnormal branching neovascular networks (BNNs). In recent years, various non-invasive imaging technologies have rapidly developed, especially the emergence of optical coherence tomography angiography (OCTA), multi-spectral imaging, and other technologies, which enable the observation of more features of PCV. In addition, these technologies are faster and less invasive compared to indocyanine green angiography (ICGA). Multi-modal imaging, which combined multiple imaging techniques, provides important references for the diagnosis and treatment of PCV with the assistance of regression models, deep learning, and other algorithms. In this study, we reviewed the non-invasive imaging techniques, multi-modal imaging diagnosis, and multi-scene therapeutic applications of PCV, with the aim of providing a reference for non-invasive multi-modal diagnosis and treatment of PCV.

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Structural and Vascular Changes of the Choroid in Polypoidal Choroidal Vasculopathy after Intravitreal Anti-VEGF Therapy

Cited by 4 publications

References 32 publications

Evaluation of the First-Dose Anti-VEGF Anatomical Response in Polypoidal Choroidal Vasculopathy Patients: Correlation with the Third-Dose Response and Risk Factor Analysis

Evaluation of the First-Dose Anti-VEGF Anatomical Response in Polypoidal Choroidal Vasculopathy Patients: Correlation with the Third-Dose Response and Risk Factor Analysis

Pachychoroid Spectrum Disorders: An Updated Review

Advances in multi-modal non-invasive imaging techniques in the diagnosis and treatment of polypoidal choroidal vasculopathy

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