September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Comparison of Treatment Outcomes Among Subtypes of Polypoidal Choroidal Vasculopathy in a Multicenter Randomized Controlled Study (EVEREST study)
Author Affiliations & Notes
  • Colin S Tan
    Ophthalmology, National Healthcare Group Eye Institute, Singapore, Singapore
    Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore
  • Louis Wei Yi Lim
    Ophthalmology, National Healthcare Group Eye Institute, Singapore, Singapore
    Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore
  • Wei Kiong Ngo
    Ophthalmology, National Healthcare Group Eye Institute, Singapore, Singapore
    Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore
  • Tock H Lim
    Ophthalmology, National Healthcare Group Eye Institute, Singapore, Singapore
    Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Colin Tan, Bayer (R), Heidelberg Engineering (R), Novartis (R); Louis Lim, None; Wei Kiong Ngo, None; Tock Lim, Heidelberg Engineering (R), Novartis (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4971. doi:
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      Colin S Tan, Louis Wei Yi Lim, Wei Kiong Ngo, Tock H Lim; Comparison of Treatment Outcomes Among Subtypes of Polypoidal Choroidal Vasculopathy in a Multicenter Randomized Controlled Study (EVEREST study). Invest. Ophthalmol. Vis. Sci. 2016;57(12):4971.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Polypoidal choroidal vasculopathy (PCV) is a disease characterized by abnormal vascular channels with terminal dilatations. PCV has high prevalence among some populations such as Asians, and a variable clinical course. In an earlier series of patients, we previously described a novel classification of 3 subtypes of PCV, with differences in long-term clinical outcomes. We aimed to describe the frequency and characteristics of PCV subtypes among patients from a multicenter randomized controlled trial, and to determine the impact of PCV subtypes on clinical outcomes.

Methods : Analysis of 60 patients with symptomatic macular PCV from the EVEREST Study. Standardized imaging protocols, including indocyanine green (ICGA) and fluorescein angiography (FA), were used by the Central Reading Center to confirm the diagnosis of PCV. The image sets were subsequently graded to classify PCV into 3 subtypes, and correlated with visual acuity (VA) and central retinal thickness (CRT). Type A PCV had polyps with interconnecting channels only, Type B had branching vascular networks with no leakage on FA, and Type C had branching vascular networks with significant leakage on FA. VA and retinal thickness on optical coherence tomography were reviewed monthly throughout the study.

Results : Of the 60 patients, 54 were gradeable for PCV subtype. Among these, 8 had Type A PCV (14.8%), 27 had Type B (50%) and 19 had Type C (35.2%). VA and reduction in retinal thickness varied significantly with PCV subtype. At 6 months, the VA was highest among patients with Type A compared to Types B and C (80.1 letters vs. 67.2 vs. 50.4 respectively, p<0.001), with the differences among the 3 subtypes statistically significant. Type A PCV gained 13 letters vs. 8.5 (Type B) and 6.9 (Type C) (p<0.001). VA≥20/40 was highest for Type A compared to Types B and C (100% vs. 51.9% vs. 10.5%, p<0.001). Retinal thickness improved in all PCV subtypes. At 6 months, the CRT was thickest for Type C PCV followed by Type B and Type A (201.7 µm vs. 188.7 µm vs. 183.8 µm, p=0.657).

Conclusions : The PCV subtype affects the visual outcome following treatment, and the PCV subtype classifcation may be applied to different populations. The distinction in clinical outcomes between the PCV subtypes is observed in the initial months following the start of treatment.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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