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Elon Van Dijk, Simona Veselinovic, Danial Mohabati, Wing Chung, Greetje Dijkman, Camiel Boon; The spectrum of polypoidal choroidal vasculopathy in Caucasians: clinical characteristics and treatment outcome. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1152.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the clinical characteristics and outcome of polypoidal choroidal vasculopathy (PCV) in Caucasian patients.
Retrospective case series of Caucasian patients with a diagnosis of PCV based on optical coherence tomography and indocyanine green angiography. Clinical characteristics and multimodal imaging were collected and assessed by an experienced retina specialist.
This study involved 74 eyes of 66 patients with PCV, with a mean age at onset of 73 years and a female preponderance of 66%. The mean number of polypoidal lesions per eye was 1 (range, 1-5 lesions), out of which 75% was located in the macula. Of the 66 patients, 33 patients (50%) had PCV associated with a drusenoidal neovascular age-related macular degeneration (AMD) phenotype, 17 patients (26%) had PCV associated with choroidal neovascularisation/branching vascular network without signs of drusenoid AMD, while 16 patients (24%) had idiopathic PCV. Only 3 eyes (18%) appeared to have an interruption of Bruch’s membrane of ≥ 30 µm that clearly caused direct communication of the polypoidal lesion with the underlying choroidal vasculature. After the diagnosis of PCV was established, in this historical cohort thermal laser was performed in 25 patients (34%), a combination of photodynamic therapy and intravitreal injection with anti-vascular endothelial growth factor in 25 patients (34%), and 24 patients (31%) received either other treatment combinations as initial therapy or no therapy. In 55% of patients, the initially performed therapy showed good anatomical recovery (resolution of intra- and subretinal fluid).When comparing baseline best-corrected visual acuity (BCVA) with the last known BCVA, there was a significant improvement in BCVA of 3 Early Treatment of Diabetic Retinopathy Study letters (p=0.047) at a visit at on average 12 months after baseline.
A spectrum of PCV can be seen in Caucasian patients. PCV associated with a drusenoidal neovascular AMD phenotype in Caucasians is phenotypically and presumably pathophysiologically more associated with neovascular AMD than it is the case in Asians with PCV, although this may not be the case for patients with PCV and no signs of drusenoidal AMD and for patients with idiopathic PCV. For the entire patient group, a moderate anatomical recovery and improvement of BCVA was observed after treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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