Spectral domain optical coherence tomography characteristics of polypoidal choroidal vasculopathy and its correlation with vision outcomes_Chinese Journal of Ocular Fundus Diseases

Authors：

WeiChunyi , LiuRan , LiJiaqing , 杨宇 ,  丁小燕

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China;

Corresponding author：

丁小燕, Email: dingxy75@gmail.com

Keywords：

Diagnostic imaging; Tomography, optical coherence; Choroid diseases/therapy; Photochemotherapy; Antibodies, monoclonal

DOI：

10.3760/cma.j.issn.1005-1015.2014.03.004

Video：

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Objective To evaluate the spectral domain optical coherence tomography (SD-OCT) characteristics of polypoidal choroidal vasculopathy (PCV) and its correlation with the visual acuity after photodynamic therapy (PDT) combined with intravitreal ranibizumab. Methods Twenty-six eyes of 26 patients with PCV diagnosed by indocyanine green angiography (ICGA) were enrolled in this study. All the patients were examined for best corrected visual acuity (BCVA), slit lamp microscope, SD-OCT, fundus fluorescein angiography (FFA) and ICGA before and 1, 3 months after treatment. The mean baseline BCVA was (31.46±16.87) letters, mean central retinal thickness (CRT) was (581.19±309.05) μm, and mean subfoveal choroidal thickness (SFCT) was (248.92±95.45) μm. Patients were divided into 2 groups according to the final visual improvement after 6 month of treatment: GR or sensitive Group (17 eyes) and PR or non-sensitive Group (9 eyes). GR group included 12 males and 5 females, with a mean age of (65.24±7.03) years, a mean CRT of (619.06±335.07) μm and a mean SFCT of (271.24±106.61) μm. There were 4 eyes with subretinal hemorrhage (SRH), 2 eyes with interface retinal fluid (IRF), 13 eyes with subretinal fluids (SRF) and 15 eyes with pigment epithelial detachment (PED). PR group included 8 males and 1female, with a mean age of (64.00±7.02) years, a mean CRT of (509.67±255.21) μm and a mean SFCT of (271.24±106.61) μm. There were 6 eyes with subretinal hemorrhage (SRH), 5 eyes with interface retinal fluid (IRF), 6 eyes with subretinal fluids (SRF) and 8 eyes with pigment epithelial detachment (PED). The difference of sex, age, CRT and SFCT between these two groups was not significant (P>0.05). The relationship of baseline SD-OCT and post-treatment BCVA was analyzed. Results On 1, 2, 3, 6 months after treatment, the BCVA were (38.46±19.81), (40.04±20.80), (42.96±21.63), (43.77±20.91) letters respectively. On 6 months after treatment, the mean CRT in GR and PR group were (360.71±276.54), (341.44±193.68) μm respectively (P>0.05). 64.71% (11/17) eyes in GR group and 22.22% (2/9) eyes in PR group had a SFCT thicker than 263μm. The difference was statistical significant between two groups [odds ratio (OR):0.052, 95% confidence interval (CI):0.005-0.533; P=0.013]. Logistic regression analysis showed that existence of IRF (OR=9.375, 95% CI: 1.299-67.645; P=0.026) or SRH (OR=6.500, 95% CI: 1.094-38.633; P=0.040) at baseline was negative prognostic factor to treatment. Conclusion Thick SFCT is a protective factor, however, existence of IRF or SRH at baseline is negative prognostic factor of final visual improvement.

Citation： WeiChunyi, LiuRan, LiJiaqing. Spectral domain optical coherence tomography characteristics of polypoidal choroidal vasculopathy and its correlation with vision outcomes. Chinese Journal of Ocular Fundus Diseases, 2014, 30(3): 241-244. doi: 10.3760/cma.j.issn.1005-1015.2014.03.004 Copy

1.	Yannuzzi LA, Wong DW, Sforzolini BS, et al. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration[J]. Arch Ophthalmol, 1999, 117:1503-1510.
2.	Koh A, Lee WK, Chen LJ, et al. EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy [J].Retina,2012,32:1453-1464.
3.	Sho K, Takahashi K, Yamada H, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics[J]. Arch Ophthalmol, 2003,121:1392-1396.
4.	Uyama M, Wada M, Nagai Y, et al. Polypoidal choroidal vasculopathy: natural history[J]. Am J Ophthalmol,2002,133:639-648.
5.	Hirami Y, Mandai M, Takahashi M, et al. Association of clinical characteristics with disease subtypes, initial visual acuity, and visual prognosis in neovascular age-related macular degeneration[J]. Jpn J Ophthalmol, 2009, 53:396-407.
6.	Bessho H, Honda S, Imai H, et al. Natural course and funduscopic findings of polypoidal choroidal vasculopathy in a Japanese population over 1 year of follow-up [J]. Retina,2011,31:1598-1602.
7.	Yuzawa M. Polypoidal choroidal vasculopathy[J]. Nippon Ganka Gakkai zasshi, 2012,116:200-231.
8.	Iida T.Diagnostic criteria for polypoidal choroidal vasculopathy and their clinical significance[J]. Nihon Ganka Gakkai Zasshi,2005,109:383-384.
9.	Gomi F, Ohji M, Sayanagi K,et al. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients[J].Ophthalmology,2008,115:141-146.
10.	Lai TY, Chan WM, Liu DT,et al. Intravitreal bevacizumab (Avastin) with or without photodynamic therapy for the treatment of polypoidal choroidal vasculopathy[J]. Br J Ophthalmol,2008,92:661-666.
11.	Koizumi H, Yamagishi T, Yamazaki T,et al. Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2011,249:1123-1128.
12.	刘冉, 李加青, 李涛, 等. 息肉样脉络膜血管病变的频域光相干断层扫描图像特征分析[J]. 中山大学学报(医学科学版), 2012, 33:841-847.
13.	Maruko I, Iida T, Saito M,et al. Clinical characteristics of exudative age-related macular degeneration in Japanese patients[J]. Am J Ophthalmol, 2007, 144:15-22.
14.	Miki A, Honda S, Kojima H,et al. Visual outcome of photodynamic therapy for typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy over 5 years of follow-up[J]. Jpn J Ophthalmol, 2013:57:301-307.
15.	Kokame GT, Yeung L, Lai JC. Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results[J]. Br J Ophthalmol,2010,94: 297-301.
16.	Mathew R, Richardson M, Sivaprasad S. Predictive value of spectral-domain optical coherence tomography features in assessment of visual prognosis in eyes with neovascular age-related macular degeneration treated with ranibizumab[J]. Am J Ophthalmol, 2013, 155:720-726.
17.	Chung SE, Kang SW, Lee JH,et al. Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration[J]. Ophthalmology, 2011,118:840-845.

1. Yannuzzi LA, Wong DW, Sforzolini BS, et al. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration[J]. Arch Ophthalmol, 1999, 117:1503-1510.
2. Koh A, Lee WK, Chen LJ, et al. EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy [J].Retina,2012,32:1453-1464.
3. Sho K, Takahashi K, Yamada H, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics[J]. Arch Ophthalmol, 2003,121:1392-1396.
4. Uyama M, Wada M, Nagai Y, et al. Polypoidal choroidal vasculopathy: natural history[J]. Am J Ophthalmol,2002,133:639-648.
5. Hirami Y, Mandai M, Takahashi M, et al. Association of clinical characteristics with disease subtypes, initial visual acuity, and visual prognosis in neovascular age-related macular degeneration[J]. Jpn J Ophthalmol, 2009, 53:396-407.
6. Bessho H, Honda S, Imai H, et al. Natural course and funduscopic findings of polypoidal choroidal vasculopathy in a Japanese population over 1 year of follow-up [J]. Retina,2011,31:1598-1602.
7. Yuzawa M. Polypoidal choroidal vasculopathy[J]. Nippon Ganka Gakkai zasshi, 2012,116:200-231.
8. Iida T.Diagnostic criteria for polypoidal choroidal vasculopathy and their clinical significance[J]. Nihon Ganka Gakkai Zasshi,2005,109:383-384.
9. Gomi F, Ohji M, Sayanagi K,et al. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients[J].Ophthalmology,2008,115:141-146.
10. Lai TY, Chan WM, Liu DT,et al. Intravitreal bevacizumab (Avastin) with or without photodynamic therapy for the treatment of polypoidal choroidal vasculopathy[J]. Br J Ophthalmol,2008,92:661-666.
11. Koizumi H, Yamagishi T, Yamazaki T,et al. Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2011,249:1123-1128.
12. 刘冉, 李加青, 李涛, 等. 息肉样脉络膜血管病变的频域光相干断层扫描图像特征分析[J]. 中山大学学报(医学科学版), 2012, 33:841-847.
13. Maruko I, Iida T, Saito M,et al. Clinical characteristics of exudative age-related macular degeneration in Japanese patients[J]. Am J Ophthalmol, 2007, 144:15-22.
14. Miki A, Honda S, Kojima H,et al. Visual outcome of photodynamic therapy for typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy over 5 years of follow-up[J]. Jpn J Ophthalmol, 2013:57:301-307.
15. Kokame GT, Yeung L, Lai JC. Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results[J]. Br J Ophthalmol,2010,94: 297-301.
16. Mathew R, Richardson M, Sivaprasad S. Predictive value of spectral-domain optical coherence tomography features in assessment of visual prognosis in eyes with neovascular age-related macular degeneration treated with ranibizumab[J]. Am J Ophthalmol, 2013, 155:720-726.
17. Chung SE, Kang SW, Lee JH,et al. Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration[J]. Ophthalmology, 2011,118:840-845.

Chinese Journal of Ocular Fundus Diseases

Spectral domain optical coherence tomography characteristics of polypoidal choroidal vasculopathy and its correlation with vision outcomes

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