Comparison of clinical features and 3-month treatment response among three different choroidal thickness groups in polypoidal choroidal vasculopathy.

Mingui Kong,Don-Il Ham,Sung Min Kim,Demetrios G Vavvas

doi:10.1371/journal.pone.0184058

Abstract

Eyes with polypoidal choroidal vasculopathy (PCV) were recently reported to have various choroidal thickness, and choroidal thickness might be associated with visual outcome in the treatment of many retinal disorders. The range of subfoveal choroidal thickness (SFCT), clinical features, and 3-month treatment response among three groups having different range of SFCT were investigated in PCV eyes. In 78 treatment-naïve eyes with PCV, SFCT was measured using optical coherence tomography. Eyes were classified into thin, medium, and thick groups, using mean and one standard deviation of SFCT. Clinical features and imaging findings were compared among the three groups. Some eyes were treated with three consecutive monthly injection of anti-vascular endothelial growth factor (VEGF) as an initial treatment. They were also classified into three thickness groups, and the short-term post-treatment improvement in visual acuity and central retinal thickness were compared among groups. The mean SFCT was 271.9 ± 135.6 μm. Twelve, 53, and 13 eyes were classified into thin (<136.3 μm), medium (136.3–407.5 μm), and thick (>407.5 μm) groups, respectively. The thin group showed older age, lower visual acuity, and a higher prevalence of fundus tessellation than the other two groups (P <0.05). In multiple linear regression analyses, baseline BCVA was correlated with baseline SFCT. Forty-six eyes completed three consecutive anti-VEGF treatments. The thin group showed no visual improvement after treatment (P = 0.141), unlike the other two groups showing visual improvement (P<0.05). Eyes with PCV have a broad range of SFCT, and PCV eyes with a thin choroid manifest worse visual function than eyes with a medium or thick choroid.

Highlights

Anti-vascular endothelial growth factor (VEGF) treatment is less useful for patients with Polypoidal choroidal vasculopathy (PCV) than in those with typical age-related macular degeneration (AMD)
The choroid is generally thicker in eyes with PCV than in those with typical AMD and healthy controls,[11,12] several studies have shown that many eyes with PCV have a thin to medium-thickness choroid.[13,14]
The standard deviation (SD) of subfoveal choroidal thickness (SFCT) in PCV eyes was larger than those of normal healthy eyes, which means the range of SFCT was wider in PCV eyes. These findings suggest that a simple SFCT measurement in an individual PCV eye may not be useful to distinguish between PCV and other retinochoroidal disorders including AMD choroidal neovascularization (CNV)

Summary

Introduction

Clinical features of thin choroidal PCV indocyanine green angiography (ICGA).[1,2] about half of patients with PCV will have a favorable natural course, the remaining half lose their vision due to recurrent bleeding and persistent exudation.[3] anti-vascular endothelial growth factor (VEGF) treatment is less useful for patients with PCV than in those with typical age-related macular degeneration (AMD). The choroid is generally thicker in eyes with PCV than in those with typical AMD and healthy controls,[11,12] several studies have shown that many eyes with PCV have a thin to medium-thickness choroid.[13,14] SFCT was associated with anatomic and functional outcome after intravitreal anti-VEGF injection treatment in patients with retinal disorders, including AMD and diabetic maculopathy.[15,16] eyes with PCV probably have a various SFCT and may have different clinical features according to the SFCT

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Discussion

Conclusion