Abstract
BackgroundTo determine the role played by vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV) based on an interventional immunology theory.MethodsEyes with PCV were divided in a masked fashion into those with choroidal hyperpermeability (HP group) and those with normal choroidal permeability (NP group) based on the indocyanine green angiograms. The inter-rater agreement rate was evaluated using Fleiss’ kappa. Patients were treated by intravitreal ranibizumab (IVB). The central choroidal thickness and central foveal thickness (CFT) at the baseline and 7 days after the treatment were measured by optical coherence tomography.ResultsAmong the 57 consecutive eyes diagnosed with PCV, 42 eyes of 42 patients met the inclusion criteria (21 eyes/HP group vs 21 eyes /NP group). Central choroidal thickness in HP group was significantly thicker than that in the NP group (P < .001, Mann–Whitney U test). The inter-rater agreement was high with a Fleiss’ kappa = 0.95, P < .0001. The percentage reduction in the CFT in HP group (14.0%) was significantly less than that in NP group (20.4%; P = .013, Mann–Whitney U test).ConclusionsEyes with PCV that are associated with choroidal hyper-permeability may not be strongly associated with VEGF-related pathology, and may not respond favorably to anti-VEGF monotherapy.
Highlights
To determine the role played by vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV) based on an interventional immunology theory
The central choroidal thickness and the central foveal thickness (CFT) at the baseline and 7 days after the intravitreal ranibizumab (IVR) were measured in the EDI-optical coherence tomography (OCT) images with a follow-up program as we have described in detail [21]
Our findings showed the role of VEGF in the disease process of PCV, and these eyes may be a sublclass of PCV eyes that are not related to VEGF pathology
Summary
To determine the role played by vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV) based on an interventional immunology theory. Typical AMD and PCV are placed under the same category of exudative AMD [3], some cases of PCV have been reported to have a unique characteristic of choroidal vascular hyperpermeability [4,5]. This may indicate that this subgroup of PCV eyes with hyperpermeability has properties that are more like those of. It was reported that the choroidal thickness is related to the AMD subtype, choroidal hyperpermeability, and gene polymorphisms [15,16,17]
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