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Louis Lim, Colin S Tan, Tock H Lim; Factors Affecting Long Term Clinical Outcomes of Polypoidal Choroidal Vasculopathy (PCV) in an Asian Population. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3150.
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© ARVO (1962-2015); The Authors (2016-present)
Polypoidal choroidal vasculopathy (PCV) occurs more commonly in Asian populations and is reported to have variable visual outcomes in the literature. However, not much is known about its long-term clinical course and factors affecting prognosis. We thus aimed to describe the epidemiology and natural history as well as factors affecting the long term clinical out comes of PCV in an Asian population
A 5-year interventional longitudinal study of 112 eyes of 102 consecutive patients with PCV seen at Tan Tock Seng Hospital, Singapore. PCV was diagnosed by 2 retinal specialists using standardized diagnostic criteria. Risk factors affecting visual outcomes were analyzed using multivariate logistic regression
The mean age of the 102 patients was 66.4 ± 9.8 years, with 87.5% Chinese, 8.9% Malay and 3.6% Indian. Of these, 62.7% were male and 37.3% females. The most common clinical feature was subretinal haemorrhage which occurred in 47.5% of eyes. PCV was located predominantly at the macula (86.0%) while 7.5% were extramacular and 6.5% peripapillary. Good visual outcomes (visual acuity [VA] ≥20/40) were achieved in 41.1% of patients, while moderate visual loss (loss of ≥ 3lines) occurred in 25% of patients. Factors affecting good visual outcome were younger age (OR= 3.52,p<0.05,) good VA (≥20/40) at presentation (OR = 8.68, p<0.001,), and smaller lesion size on indocyanine green (ICG) (4.37mm2 vs. 11.11mm2,p=0.007). Poor initial VA at start (OR = 6.06, p<0.05,) and the presence of significant leakage on angiography (30.8% vs. 3.8%, p=0.024) predicted poor visual outcomes (final VA ≤20/200).
PCV has a moderate clinical course in an Asian population. The risk factors for good visual outcome were younger age, good presenting VA and smaller lesion size, while leakage on angiography and poor presenting VA conferred a higher risk for poor visual outcome.
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