Spectral domain optical coherence tomography characteristics of polypoidal choroidal vasculopathy and its correlation with vision outcomes

Abstract

Objective To evaluate the spectral domain optical coherence tomography (SD-OCT) characteristics of polypoidal choroidal vasculopathy (PCV) and its correlation with the visual acuity after photodynamic therapy (PDT) combined with intravitreal ranibizumab.Methods Twenty-six eyes of 26 patients with PCV diagnosed by indocyanine green angiography (ICGA) were enrolled in this study.All the patients were examined for best corrected visual acuity (BCVA),slit lamp microscope,SD-OCT,fundus fluorescein angiography (FFA) and ICGA before and 1,3 months after treatment.The mean baseline BCVA was (31.46±16.87) letters,mean central retinal thickness (CRT) was (581.19±309.05) μm,and mean subfoveal choroidal thickness (SFCT) was (248.92±95.45) μm.Patients were divided into 2 groups according to the final visual improvement after 6 month of treatment:GR or sensitive Group (17 eyes) and PR or non-sensitive Group (9 eyes).GR group included 12 males and 5 females,with a mean age of (65.24± 7.03) years,a mean CRT of (619.06±335.07) μm and a mean SFCT of (271.24±±106.61) μm.There were 4 eyes with subretinal hemorrhage (SRH),2 eyes with interface retinal fluid (IRF),13 eyes with subretinal fluids (SRF) and 15 eyes with pigment epithelial detachment (PED).PR group included 8 males and 1female,with a mean age of (64.00±7.02) years,a mean CRT of (509.67±255.21) μm and a mean SFCT of (271.24 ± 106.61) μm.There were 6 eyes with subretinal hemorrhage (SRH),5 eyes with interface retinal fluid (IRF),6 eyes with subretinal fluids (SRF) and 8 eyes with pigment epithelial detachment (PED).The difference of sex,age,CRT and SFCT between these two groups was not significant (P＞ 0.05).The relationship of baseline SD-OCT and post-treatment BCVA was analyzed.Results On 1,2,3,6 months after treatment,the BCVA were (38.46±19.81),(40.04±20.80),(42.96±21.63),(43.77±20.91) letters respectively.On 6 months after treatment,the mean CRT in GR and PR group were (360.71±276.54),(341.44±193.68) μmrespectively (P＞0.05).64.71％ (11/17) eyes in GR group and 22.22％ (2/9) eyes in PR group had a SFCT thicker than 263μm.The difference was statistical significant between two groups [odds ratio (OR):0.052,95 ％ confidence interval (CI):0.005-0.533; P=0.013].Logistic regression analysis showed that existence of IRF (OR=9.375,95％ CI:1.299-67.645 ; P=0.026) or SRH (OR=6.500,95％CI:1.094-38.633 ; P=0.040) at baseline was negative prognostic factor to treatment.Conclusion Thick SFCT is a protective factor,however,existence of IRF or SRH at baseline is negative prognostic factor of final visual improvement. Key words: Diagnostic imaging; Tomography, optical coherence; Choroid diseases/therapy; Photochemotherapy; Antibodies, monoclonal