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June 2020
Volume 61, Issue 7
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ARVO Annual Meeting Abstract  |   June 2020
Evolution of Polypoidal Lesions after Anti-VEGF Treatment Using Swept-Source Optical Coherence Tomography Angiography in Polypoidal Choroidal Vasculopathy
Mengxi Shen; Qiyu Bo; Minlu Song; Giovanni Gregori; Xiaodong Sun; Fenghua Wang; Philip J Rosenfeld
Author Affiliations & Notes
  • Mengxi Shen
    Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Qiyu Bo
    Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Minlu Song
    Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Giovanni Gregori
    Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Xiaodong Sun
    Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Fenghua Wang
    Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Philip J Rosenfeld
    Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Mengxi Shen, None; Qiyu Bo, None; Minlu Song, None; Giovanni Gregori, Carl Zeiss Meditec (F), Carl Zeiss Meditec (P); Xiaodong Sun, None; Fenghua Wang, None; Philip Rosenfeld, Carl Zeiss Meditec (F), Carl Zeiss Meditec (C)
  • Footnotes
    Support  Grants from the National Eye Institute (R01EY024158, R01EY028753), Carl Zeiss Meditec, the Salah Foundation, an unrestricted grant from the Research to Prevent Blindness, Inc., New York, NY, and the National Eye Institute Center Core Grant (P30EY014801) to the Department of Ophthalmology, University of Miami Miller School of Medicine.
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4816. doi:
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      Mengxi Shen, Qiyu Bo, Minlu Song, Giovanni Gregori, Xiaodong Sun, Fenghua Wang, Philip J Rosenfeld; Evolution of Polypoidal Lesions after Anti-VEGF Treatment Using Swept-Source Optical Coherence Tomography Angiography in Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4816.

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Abstract

Purpose : To describe the growth pattern of polypoidal lesions in polypoidal choroidal vasculopathy (PCV) eyes after anti-VEGF treatment using swept-source optical coherence tomography angiography (SS-OCTA).

Methods : Patients with PCV after anti-VEGF treatment were retrospectively reviewed. All eyes were imaged using a SS-OCTA instrument (PLEX Elite 9000, Carl Zeiss Meditec, Dublin, CA) and were followed for at least one year.

Results : Forty-two eyes of 38 patients with PCV were entered in this study. Polypoidal lesions were found to evolve into a flat Type 1 choroidal neovascularization (CNV) in five eyes (12%). In two eyes, a polypoidal lesion was detected in a notched serous or hemorrhagic pigment epithelial detachment (PED) and then grew into a flat CNV underneath the PED area after anti-VEGF treatment within 10 months and 3 years respectively (Figure 1). In the other three eyes, the polypoidal lesion initially manifested as a sharp or dome-shaped PED, then grew larger into a relatively flat Type 1 CNV after anti-VEGF treatment within an average of 10 months (Figure 2).

Conclusions : Using SS-OCTA imaging, polypoidal lesions, PEDs and CNVs can be clearly visualized. We observed a number of cases where the polypoidal lesions evolve over time into flat Type 1 CNV and grow extensively underneath the associated PEDs.

This is a 2020 ARVO Annual Meeting abstract.

 

Swept-source optical coherence tomography Angiography (OCTA) imaging of the right eye of a 67-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a notched pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Ten months later, OCTA en face Angio image showing the polypoidal lesion grew into a flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.
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Swept-source optical coherence tomography Angiography (OCTA) imaging of the right eye of a 67-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a notched pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Ten months later, OCTA en face Angio image showing the polypoidal lesion grew into a flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.

Swept-source optical coherence tomography Angiography (OCTA) imaging of the right eye of a 67-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a notched pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Ten months later, OCTA en face Angio image showing the polypoidal lesion grew into a flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.

Swept-source optical coherence tomography Angiography (OCTA) imaging of the right eye of a 67-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a notched pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Ten months later, OCTA en face Angio image showing the polypoidal lesion grew into a flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.
View OriginalDownload Slide
 
Swept-source optical coherence tomography Angiography (OCTA) imaging of the left eye of a 59-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a sharp pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Seven months later, OCTA en face Angio image showing the polypoidal lesion grew larger into a relatively flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.
View OriginalDownload Slide

Swept-source optical coherence tomography Angiography (OCTA) imaging of the left eye of a 59-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a sharp pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Seven months later, OCTA en face Angio image showing the polypoidal lesion grew larger into a relatively flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.

Swept-source optical coherence tomography Angiography (OCTA) imaging of the left eye of a 59-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a sharp pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Seven months later, OCTA en face Angio image showing the polypoidal lesion grew larger into a relatively flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.

Swept-source optical coherence tomography Angiography (OCTA) imaging of the left eye of a 59-year-old Asian man with PCV. A) OCTA en face Angio image showing a polypoidal lesion was detected in a sharp pigment epithelial detachment, B) B scan with flow corresponding to the blue line in A, C) Seven months later, OCTA en face Angio image showing the polypoidal lesion grew larger into a relatively flat Type 1 CNV lesion after 3 anti-VEGF treatment, D) B scan with flow corresponding to the blue line in C.
View OriginalDownload Slide

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