Abstract
Purpose. To evaluate the clinical characteristics and long-term prognosis of pachychoroid neovasculopathy (PCN) when compared with type 1 neovascular age-related macular degeneration (nAMD). Methods. We retrospectively analyzed 30 and 60 patients whose eyes were diagnosed as treatment-naïve PCN or type 1 nAMD, respectively. All subjects were followed up for 5 years. Baseline angiographic characteristics and long-term clinical outcomes were compared between the two groups. Results. PCN group consisted of patients of younger age and represented more choroidal vascular hyperpermeability, polypoidal lesion, and history of central serous chorioretinopathy (CSC) at the time of diagnosis (all p < 0.01). During the 5-year follow-up period, individuals in the PCN group received significantly fewer injections and reported better visual acuity compared to individuals in the type 1 nAMD group. A progressive decrease in the subfoveal choroidal thickness was observed in the type 1 nAMD group, while the thick choroid was maintained in the PCN group during the 5-year follow-up period. Conclusions. PCN developed in younger patients with a higher propensity of forming polypoidal lesions and a history of CSC. Long-term outcomes revealed that PCN had a thicker choroid and better visual prognosis with fewer number of intravitreal injection than that of type 1 nAMD.
Highlights
Type 1 choroidal neovascularization (CNV) is the most common subtype of neovascular age-related macular degeneration that is characterized by localization of abnormal vessels beneath the retinal pigment epithelium (RPE)
New clinical entities have been suggested as pachychoroid spectrum disease that shares common features of choroidal thickening, comprising central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PCN), and polypoidal choroidal vasculopathy (PCV) [2,3,4]. e CNV induced by pachychoroid disease is characterized by the formation of a thick choroid with type 1 CNV, and its etiologies are likely to be different from type 1 neovascular age-related macular degeneration (nAMD) [2,3,4]
Since the PCN was published as a criterion of CNV, many studies have been published about PCN displaying a shared morphology with type 1 CNV without evidence of nAMD [2, 3]
Summary
To evaluate the clinical characteristics and long-term prognosis of pachychoroid neovasculopathy (PCN) when compared with type 1 neovascular age-related macular degeneration (nAMD). Baseline angiographic characteristics and long-term clinical outcomes were compared between the two groups. PCN group consisted of patients of younger age and represented more choroidal vascular hyperpermeability, polypoidal lesion, and history of central serous chorioretinopathy (CSC) at the time of diagnosis (all p < 0.01). During the 5-year follow-up period, individuals in the PCN group received significantly fewer injections and reported better visual acuity compared to individuals in the type 1 nAMD group. Long-term outcomes revealed that PCN had a thicker choroid and better visual prognosis with fewer number of intravitreal injection than that of type 1 nAMD
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