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Graefes Arch Clin Exp Ophthalmol. 2019 May 16. doi: 10.1007/s00417-019-04317-y. [Epub ahead of print]

Enlargement of polypoidal choroidal vasculopathy lesion without exudative findings assessed in en face optical coherence tomography images.

Kwon HJ1,2, Lee JJ1,3, Park SW1,3, Byon IS1,2, Lee JE4,5.

Author information

1
Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea.
2
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
3
Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro Seo-gu, Busan, 49241, South Korea.
4
Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea. jlee@pusan.ac.kr.
5
Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro Seo-gu, Busan, 49241, South Korea. jlee@pusan.ac.kr.

Abstract

PURPOSE:

This study aimed to investigate growth of polypoidal choroidal vasculopathy (PCV) without exudative findings assessed in en face optical coherence tomography (OCT) images and its clinical implications.

METHODS:

Fifty patients who were diagnosed with PCV and had no disease activity after treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF) were included. Patients were followed up for at least 12 months. Measurement of best-corrected visual acuity and volume scan using swept-source OCT was performed at each visit. The neovascular area of PCV was assessed using en face OCT. Growth group comprised patients who showed increase in neovascular area in the en face images without exudative findings. The main outcome measure was relationship between growth of PCV and recurrence.

RESULTS:

Among 50 eyes of 50 patients with average age of 68.5 ± 8.6 years, 25 (50%) eyes were included in the growth group. Exudative recurrence was noted more frequently in the growth group (18 eyes, 72%) than in the non-growth group (6 eyes, 24%, P = .002, odds ratio = 8.143). More injections were performed in the growth group (4.7 ± 2.1 vs. 1.9 ± 2.4, P = .002), but there was no difference in visual acuity at 1 year. After an exudative recurrence following the lesion growth, more frequent injections were required than before the recurrence to achieve no disease activity (P = .002).

CONCLUSION:

PCV lesion growth without fluid preceded exudative recurrence and worsening of response to anti-VEGF treatment.

KEYWORDS:

Anti-vascular endothelial growth factor; En face optical coherence tomography; Non-exudative enlargement; Polypoidal choroidal vasculopathy

PMID:
31098753
DOI:
10.1007/s00417-019-04317-y

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