June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
SD-OCT Characteristics of Complete or Partial Polypoidal Regression Compared with ICG Angiography Following Anti-VEGF Treatment of Polypoidal Choroidal Vasculopathy
Author Affiliations & Notes
  • Voraporn Chaikitmongkol
    Chiang Mai University, Amphur Muang Chiang Mai, Thailand
  • Thanaphat Chaovisitseree
    Chiang Mai University, Amphur Muang Chiang Mai, Thailand
  • Direk Patikulsila
    Chiang Mai University, Amphur Muang Chiang Mai, Thailand
  • Paradee Kunavisarut
    Chiang Mai University, Amphur Muang Chiang Mai, Thailand
  • Nopasak Phasukkijwatana
    Siriraj Hospital Mahidol University, Thailand
  • Janejit Choovuthayakorn
    Chiang Mai University, Amphur Muang Chiang Mai, Thailand
  • Nawat Watanachai
    Chiang Mai University, Amphur Muang Chiang Mai, Thailand
  • Pawinee Boonyot
    Srinakharinwirot University, Thailand
  • Thammasin Ingviya
    Prince of Songkhla University, Thailand
  • Neil M Bressler
    Johns Hopkins University, Maryland, United States
  • Footnotes
    Commercial Relationships   Voraporn Chaikitmongkol, Allergan (R), Bayer (F), Bayer (R), Novartis (R), Roche (F); Thanaphat Chaovisitseree, None; Direk Patikulsila, Alcon (R), Allergan (R), Bayer (R), Novartis (R); Paradee Kunavisarut, Bayer (R), Novartis (R); Nopasak Phasukkijwatana, Allergan (R); Janejit Choovuthayakorn, Alcon (R), Allergan (R), Bayer (R), Novartis (R); Nawat Watanachai, Alcon (R), Allergan (R), Bayer (R), Novartis (R); Pawinee Boonyot, None; Thammasin Ingviya, None; Neil Bressler, Bayer (F), Novartis (F), Roche (Genentech) (F), Samsung (F)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2543. doi:
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      Voraporn Chaikitmongkol, Thanaphat Chaovisitseree, Direk Patikulsila, Paradee Kunavisarut, Nopasak Phasukkijwatana, Janejit Choovuthayakorn, Nawat Watanachai, Pawinee Boonyot, Thammasin Ingviya, Neil M Bressler; SD-OCT Characteristics of Complete or Partial Polypoidal Regression Compared with ICG Angiography Following Anti-VEGF Treatment of Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2543.

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

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Abstract

Purpose : Complete polypoidal regression on indocyanine green angiography (ICGA)is a common outcome in polypoidal choroidal vasculopathy (PCV) trials. However, ICGA is not always available in a clinical practice setting. Therefore, this study explored accuracy of spectral-domain optical coherence tomography (SD-OCT) characteristics to identify complete or partial polypoidal regression during PCV treatments.

Methods : With IRB approval, PCV eyes with SD-OCT and ICGA at baseline and 3 mo. after anti-VEGF treatments (August 2013 to February 2018) were reviewed. Two standardized graders confirmed PCV diagnosis using ICGA images (EVEREST criteria) at baseline, grading complete or partial regression after treatments. Two other graders reviewed SD-OCT, determining intralesional characteristics of pigment epithelial detachment (PED) corresponding to polypoidal lesions. Disagreements had open adjudications.

Results : 130 polypoidal lesions (65 pre- and 65 post-treatment lesions) of 39 PCV eyes (39 subjects; 54% female; mean age [±SD] 64.6 [±8.2] years) were evaluated. Of 65 post-treatment lesions, ICGA showed 48% complete and 52% partial regression. Four SD-OCT characteristics of polypoidal lesions observed after treatments included: A) “PED disappearance” or B) “PED with internal homogeneous hyperreflectivity and poor-defined RPE” had 86% accuracy (95%CI, 75%-93%), 94% specificity, 77% sensitivity for complete polypoidal regression; presence of C) “PED with internal heterogeneous reflectivity” had 85% accuracy (95%CI, 74%-92%), 90% specificity, 79% sensitivity for partial regression, and presence of D) “PED with internal hyperreflectivity with well-defined RPE” had 51% accuracy (95%CI, 38%-63%), 85% specificity, 13% sensitivity for complete regression.

Conclusions : When ICGA is unavailable, SD-OCT characteristics may provide high accuracy in identifying complete or partial polypoidal regression in PCV.

This is a 2020 ARVO Annual Meeting abstract.

 

Figure 1. SD-OCT characteristics of post-treatment polypoidal lesions. A) PED disappearance, B) PED with internal homogeneous hyperreflectivity (arrow) with poor-defined RPE, C) PED with internal homogeneous hyperreflectivity (arrow) with well-defined RPE, and D) PED with heterogeneous reflectivity (arrow). SD-OCT, spectral-domain optical coherence tomography; PED, pigment epithelial detachment.

Figure 1. SD-OCT characteristics of post-treatment polypoidal lesions. A) PED disappearance, B) PED with internal homogeneous hyperreflectivity (arrow) with poor-defined RPE, C) PED with internal homogeneous hyperreflectivity (arrow) with well-defined RPE, and D) PED with heterogeneous reflectivity (arrow). SD-OCT, spectral-domain optical coherence tomography; PED, pigment epithelial detachment.

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