EFFECTS OF VITREOMACULAR ADHESION ON ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT FOR POLYPOIDAL CHOROIDAL VASCULOPATHY

Abstract

To evaluate the effect of posterior vitreomacular adhesion (VMA), documented by optical coherence tomography, on the outcome of anti-vascular endothelial growth factor treatment of polypoidal choroidal vasculopathy. Medical records of 102 patients (104 eyes) with polypoidal choroidal vasculopathy were retrospectively reviewed and categorized according to the presence of posterior VMA into 2 subgroups: VMA positive (+) group (23 eyes) and VMA negative (-) group (81 eyes). Best-corrected visual acuity and central macular thickness after antivascular endothelial growth factor treatment were compared between the 2 groups at baseline and at 1 month, 3 months, 6 months, and 12 months. At the last follow-up, average number of injections was 4.82 ± 1.27 in the VMA (+) group and 4.92 ± 1.45 in the VMA (-) group. After injection, the mean logarithm of the minimum angle of resolution of best-corrected visual acuity improved from 0.81 ± 0.53 (Snellen equivalent, 20/129) to 0.67 ± 0.52 (Snellen equivalent, 20/93) in the VMA (+) group (P = 0.01) and from 0.79 ± 0.50 (Snellen equivalent, 20/123) to 0.64 ± 0.58 (Snellen equivalent, 20/91) in the VMA (-) group (P = 0.02). Average central macular thickness decreased from 354.4 ± 124.5 μm to 249.6 ± 112.5 μm in the VMA (+) group (P = 0.01) and from 361.2 ± 140.2 μm to 267.3 ± 103.5 μm in the VMA (-) group (P = 0.01). Polyp regression rate was 21.7% (5 eyes of 23 eyes) in the VMA (+) group and 22.2% (18 eyes of 81 eyes) in the VMA (-) group. There was no statistically significant difference in the best-corrected visual acuity improvement, central macular thickness improvement, and polyp regression rate between the groups. Unlike typical age-related macular degeneration, posterior VMA was not associated with a visual outcome after intravitreal antivascular endothelial growth factor for polypoidal choroidal vasculopathy.