Abstract
Purpose: :
To evaluate the responsiveness to intravitreal ranibizumab (IVR) for treating polypoidal choroidal vasculopathy (PCV) in relation to choroidal vascular hyperpermeability.
Methods: :
Thirty-three eyes of 33 patients with PCV, who have neither apparent hemorrhage nor fibrin, but have pure serous exudation, were examined retrospectively. Indocyanine green angiography (ICGA) was performed on all patients to be classified into hyperpermeability group (HP group) or normal permeability group (NP group), which was determined by 3 masked observers based upon ICGA findings. All patients were treated by IVR. Baseline choroidal thickness and retinal thickness before and 7 days after IVR at fovea were measured by enhanced depth imaging optical coherence tomography (OCT) technique with Spectralis® OCT device. Reduction rate was calculated about retinal thickness before and after IVR. Data concerning gender, age, treated eye, contralateral eye involvement, visual acuity, lens status, and refraction were also obtained by chart review. The Mann-Whitney U test and Chi-square test were used for statistical analysis.
Results: :
Sixteen eyes with choroidal hyperfluorescence on ICGA were classified into HP group and 17 eyes without it were into NP group. Baseline choroidal thickness in HP group was significantly greater than that in NP group (398±95.7 microns vs 201±53.5 microns; P<.001). Reduction rate of retinal thickness in HP group was less than that in NP group (14.9±8.0 % vs 21.0±8.4 %; P=0.04). In the other data, only gender was significantly different between HP group and NP group (14 men/ 2 women vs 9/ 8; P=0.03).
Conclusions: :
Those eyes with PCV associating with active choroidal hyperpermeability were less responsive to IVR, suggesting that choroidal hyperfluorescence in PCV is less dependent on VEGF-related pathology.
Keywords: age-related macular degeneration • choroid • vascular endothelial growth factor