Abstract
Purpose :
To report the prevalence and clinical characteristics of polypoidal choroidal vasculopathy (PCV) at 3 tertiary referral centers, focusing on racial differences in Caucasians, African American, and Asian subjects.
Methods :
We reviewed the medical records of patients diagnosed with treatment naïve exudative AMD between January 2016 and December 2020 at the following institutions: Northwestern University, University of Chicago, and Hyogo College of Medicine. We diagnosed PCV in this cohort based on fundus photos and OCT characteristics, defined as the presence of: two of the following three characteristics: sub-retinal pigment epithelium (RPE) ring-like lesion, complex RPE elevation, or sharp-peaked pigment epithelium detachment. We also report the visual and anatomic outcomes in patients who completed longitudinal follow-up of 12 months.
Results :
A total of 123 patients with treatment-naïve PCV— 21 Caucasians, 18 African Americans, and 84 Asians— were identified. PCV prevalence in the overall AMD cohort was 6.89 % among Caucasian subjects, 33.3 % in African Americans, and 36.68 % in Asians. The prevalence of hard exudates and subretinal hemorrhage was highest in African American patients (55.6% and 72.0%) and considerably lower in Asians (32.1% and 38.1%) and Caucasians (14.3% and 33.3%). Baseline BCVA was also worse in African American patients (mean Log MAR: 0.793). Caucasian patients had significantly lower incidence of pachyvessels (28.6%) and more soft drusen (66.6%) compared to African Americans and Asians. Ninety-four patients — 20 Caucasian, 11 African American, and 63 Asians— were followed for more than one year. Mean BCVA (LogMar) improved significantly from baseline to month 12 (0.394 to 0.211) in the overall cohort (P<0.001), though this did not hold true for the Caucasian subgroup ((0.362-tp 0.361; P = 0.56).
Conclusions :
We found significant differences in the prevalence and clinical characteristics of PCV amongst the three racial groups. These pathophysiologic differences deserve further study since they can have important impact on prognosis and treatment outcomes.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.