Effects of Choroidal Vascular Hyperpermeability on Anti–Vascular Endothelial Growth Factor Treatment for Polypoidal Choroidal Vasculopathy

Abstract

To evaluate the effect of choroidal vascular hyperpermeability, as determined using indocyanine green angiography (ICGA), on the outcome of anti-vascular endothelial growth factor (VEGF) treatment for polypoidal choroidal vasculopathy (PCV). Retrospective comparative series. Based on the presence of choroidal vascular hyperpermeability on ICGA, 103 eyes (101 patients) with PCV were categorized into 2 subgroups: choroidal vascular hyperpermeability (+) group (41 eyes) and choroidal vascular hyperpermeability (-) group (62 eyes). All subjects were treatment naïve and treated by anti-VEGF with initial 3 loading injections per month, followed by an as-needed reinjection. Best-corrected visual acuity (BCVA) and central macular thickness after treatment were compared between the 2 groups at baseline and at 3, 6, 9, and 12months. At 12months after treatment, mean BCVA was significantly improved from 0.68 logarithm of the minimal angle of resolution (logMAR) (20/95 Snellen equivalent) to 0.50 logMAR (20/63 Snellen equivalent) in the choroidal vascular hyperpermeability (-) group (P= .01); however, there was no significant improvement, from 0.79 logMAR (20/123 Snellen equivalent) to 0.74 logMAR (20/109 Snellen equivalent), in the choroidal vascular hyperpermeability (+) group. In paired comparisons of BCVA between baseline and each follow-up visit, the choroidal vascular hyperpermeability (-) group showed significant improvement of BCVA at every follow-up visit (P < .05); however, the choroidal vascular hyperpermeability (+) group did not show significant visual improvement after 9months (P > .05). The therapeutic response to anti-VEGF treatment for PCV in patients with choroidal vascular hyperpermeability decreased over time. Choroidal vascular hyperpermeability was associated with an inferior visual outcome after intravitreal anti-VEGF treatment for PCV.