Clinical features and prognosis of polypoidal choroidal vasculopathy with different morphologies of branching vascular network on optical coherence tomography angiography

Shang-Te Ma,Tso-Ting Lai,Chung-May Yang,Chang-Hao Yang,Tzyy-Chang Ho,Yun-Chia Chang,Chu-Hsuan Huang,Cheng-Guo Cheng,Yi-Ting Hsieh

doi:10.1038/s41598-021-97340-1

Abstract

This study highlights the clinical features and treatment response of polypoidal choroidal vasculopathy (PCV) among three different branching vascular network (BVN) morphologies in optical coherence tomography angiography (OCTA), and further correlates the BVN features with those under fluorescent angiography (FA) and indocyanine green angiography (ICGA). In total, we reviewed 70 eyes with PCV followed up for > 12 months. OCTA, ICGA and FA images were obtained at baseline and post-treatments. BVN was assessed using OCTA and divided into three types by a previously described BVN classification: type 1 (trunk), type 2 (glomeruli), and type 3 (stick). At baseline, type 1 BVN had the poorest vision and thinnest subfoveal choroidal thickness (SFCT), whereas type 3 had the best vision and thickest SFCT. The aforementioned trend sustained after treatments. Each BVN morphology in OCTA showed typical features in FA + ICGA and encompassed significant correlation (p = 0.004). In conclusion, OCTA is an innovative imaging tool for the detection and classification of BVN in PCV. Furthermore, OCTA has advantages of being noninvasive and free of systemic toxicities. The BVN can be divided into three types based on morphological characteristics in OCTA, which play crucial roles in clinical presentations and treatment outcomes.

Highlights

This study highlights the clinical features and treatment response of polypoidal choroidal vasculopathy (PCV) among three different branching vascular network (BVN) morphologies in optical coherence tomography angiography (OCTA), and further correlates the branching vascular networks (BVNs) features with those under fluorescent angiography (FA) and indocyanine green angiography (ICGA)
Tan et al proposed an innovative classification system of dividing PCV lesions into three BVN subtypes based on ICGA and fluorescent angiography (FA) images, which successfully predicted visual prognosis at 5 years[17]
We found that the NTUH morphological classification of BVN through OCTA and the features of BVN in ICGA + FA proposed by Tan et al had significant correlations (Table 2, p = 0.004, chi-square test)