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Gregg T. Kokame, Kelli Kokame, Keke Liu, Kyle Kaneko; Clinical Characteristic of and Anti-VEGF Resistance in Polypoidal Choroidal Vasculopathy in Caucasian Patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):833.
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© ARVO (1962-2015); The Authors (2016-present)
To define the clinical characteristics of polypoidal choroidal vasculopathy (PCV) in the Caucasian population, which is understudied, and to assess the prevalence of anti-VEGF resistance in Caucasian patients with PCV.
Data was collected retrospectively through chart reviews of patients seen at the Retina Consultants of Hawaii and Hawaii Macula and Retina Institute from January 1, 2007 – August 31, 2017. PCV was confirmed by indocyanine green angiography (ICGA) in 49 patients. Patients were excluded if they had myopic degeneration, retinal vein or artery occlusion, retinal detachment, inflammatory disease, or diabetic retinopathy. Treatment response was based on an anatomic definition of anti-VEGF resistance, which included persistent intraretinal or subretinal edema after 4 anti-VEGF injections.
49 Caucasian patients (53.06% male, 46.94% female) were diagnosed with PCV at a mean age of 72.43 years. 44 patients (89.8%) had PCV unilaterally, while 5 patients (10.2%) had PCV bilaterally. Of the 54 eyes in the study, 43 (79.6%) had PCV present in the macular region, 9 (16.7%) had PCV present in the peripapillary region, and 2 (3.7%) had PCV present in both regions. 37 eyes were included in the treatment analysis with 20 eyes (54.05%) showing resistance to treatment.
Caucasian PCV is more often unilateral, unlike the initial case reports, and presents more commonly in the macular region rather than the peripapillary region. However, peripapillary PCV in Caucasian patients can be more prominent going completely around the nerve, including nasally. PCV was found to be resistant to anti-VEGF treatments in 54% of cases, which makes this subtype of type I subretinal neovascularization extremely important to identify, as other treatments may be considered.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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