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Katja B. Hatz, Christian Pruente; Prevalence Of Polypoidal Choroidal Vasculopathy Among Caucasian Bad-responders To Antivegf-treatment In Exudative Amd. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3805.
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To investigate the prevalence of polypoidal choroidal vasculopathy (PCV) and other special features such as retinal angiomatous proliferation (RAP) in eyes with exudative AMD of Caucasian patients that respond badly to anti-VEGF therapy.
Analysis of eyes treated with ≥ 8 ranibizumab injections for exudative AMD in a clinical routine setting. As 5-6 injections during the first year were applied in most PRN trials eyes were categorized by the time interval between injection 1 and 6 (group 1 < 12 months; group 2 ≥ 12 months). Eyes were reevaluated with Indocyanine green angiography (ICGA). Frequencies of PCV, RAP and feeder vessels were compared for both groups.
Out of 753 eyes treated with ranibizumab for exudative AMD for at least one year 213 eyes received ≥ 8 injections. 11 had to be excluded from analysis because ICG angiography could not be performed. Of 149 eyes in group 1 21.5% showed PCV and 10.7% RAP in ICG angiography. The prevalence for PCV (3.8%) in group 2 (53 eyes) was significant lower, while there was no significant difference for RAP (13.2%). Mean interval between injection 1 and 6 was 8.7 months for PCV eyes, but 10.8 months for non-PCV eyes and 10.4 for all eyes. AMD type CNV could be found in 67.8% (gr. 1) and 83% (gr. 2); 30.9% (gr. 1) and 26.4% (gr. 2) showed feeder vessels as signs of mature CNV. In both groups there was no difference in the amount of large geographic atrophies preceding small occult CNV was found (4% and 5.7% respectively).
PCV is underestimated in the Caucasian population, particularly if frequent retreatment is needed in a PRN setting. ICG angiography is an important diagnostic tool, that can provide important information for treatment strategies even in Caucasian patients.
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