Abstract
Purpose :
To investigate choroidal vascular brightness intensity using ultra-widefield indocyanine green angiography (UWF ICGA) images of polypoidal choroidal vasculopathy (PCV) and to analyze its association with treatment outcomes.
Methods :
A review of the medical records of treatment naïve subfoveal PCV patients who received intravitreal anti-VEGF injection was conducted. Choroidal vascular brightness intensity was measured by extracting enhanced pixels of choroidal vessels after adjusting the reference brightness across the images to be the same. The distribution of choroidal vascular brightness intensity, subfoveal choroidal thickness (SFCT), dry macula after loading phase, and the proportion of subjects with a gain of 15 or more letters from baseline best-corrected visual acuity letter score were evaluated. The relationship between choroidal vascular brightness intensity and treatment outcomes was analyzed. Receiver-operating characteristic (ROC) curves analysis was performed to compare the predictive performance of choroidal vascular density (CVD) and choroidal vascular brightness intensity.
Results :
Forty-two eyes of 42 patients with PCV were included in this study. The choroidal vascular brightness intensity was higher at the posterior than that of the periphery, and the inferior quadrants were brighter than the superior quadrants. Increased choroidal vascular brightness intensity from the posterior pole was more significantly associated with thicker SFCT, higher dry rate after loading injections, and more 3-line gainers at 12 months, when compared to that of periphery. In the multiple regression analysis, fluid resolution after loading injections and 3-line gainer at 12 months were significantly associated with thin SFCT (p=0.020, p=0.016), and decreased CVD (p=0.012, p=0.010) and choroidal vascular brightness intensity (p=0.004, p=0.005). The choroidal vascular brightness intensity had higher area under curve than CVD for fluid resolution after loading injections (AUC=0.828, AUC=0.648) and 3-line gainer at 12 months (AUC=0.805, AUC=0.606).
Conclusions :
Choroidal vascular brightness intensity suggesting venous outflow congestion can be used as a new biomarker in predicting treatment outcomes in PCV.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.