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Enlargement of polypoidal choroidal vasculopathy lesion without exudative findings assessed in en face optical coherence tomography images

  • Retinal Disorders
  • Published:
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Abstract

Purpose

This study aimed to investigate growth of polypoidal choroidal vasculopathy (PCV) without exudative findings assessed in en face optical coherence tomography (OCT) images and its clinical implications.

Methods

Fifty patients who were diagnosed with PCV and had no disease activity after treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF) were included. Patients were followed up for at least 12 months. Measurement of best-corrected visual acuity and volume scan using swept-source OCT was performed at each visit. The neovascular area of PCV was assessed using en face OCT. Growth group comprised patients who showed increase in neovascular area in the en face images without exudative findings. The main outcome measure was relationship between growth of PCV and recurrence.

Results

Among 50 eyes of 50 patients with average age of 68.5 ± 8.6 years, 25 (50%) eyes were included in the growth group. Exudative recurrence was noted more frequently in the growth group (18 eyes, 72%) than in the non-growth group (6 eyes, 24%, P = .002, odds ratio = 8.143). More injections were performed in the growth group (4.7 ± 2.1 vs. 1.9 ± 2.4, P = .002), but there was no difference in visual acuity at 1 year. After an exudative recurrence following the lesion growth, more frequent injections were required than before the recurrence to achieve no disease activity (P = .002).

Conclusion

PCV lesion growth without fluid preceded exudative recurrence and worsening of response to anti-VEGF treatment.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea

    Han Jo Kwon, Jae Jung Lee, Sung Who Park, Ik Soo Byon & Ji Eun Lee

  2. Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea

    Han Jo Kwon & Ik Soo Byon

  3. Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro Seo-gu, Busan, 49241, South Korea

    Jae Jung Lee, Sung Who Park & Ji Eun Lee

Authors
  1. Han Jo Kwon
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  4. Ik Soo Byon
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  5. Ji Eun Lee
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Contributions

HJK and JEL contributed to the design and execution of the study; HJK and JJL performed the data collection; HJK, JJL, and JEL initiated the data analysis and interpretation of data; and HJK, JJL, SWP, ISB, and JEL prepared, reviewed, and approved the manuscript.

Corresponding author

Correspondence to Ji Eun Lee.

Ethics declarations

Conflict of interest

JEL (advisory board and consultant for Alcon, Allergan, Bayer, and Novartis, research fund from Bayer and Novartis). None of the other authors have any financial or other conflicts of interest to disclose.

Informed consent

Informed consent was waived for the study by the Institutional Review Board.

Ethics approval

Institutional Review Board of Pusan National University Hospital.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Not commissioned; externally peer reviewed.

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Supplemental Fig. 1

Recurrence and treatment response between growth group and nongrowth group. On en face optical coherence tomography images, 25 (50%) eyes showed non-exudative enlargement of the lesion. In the growth group, exudative recurrence occurred in 18 (72.0%) eyes, whereas in the non-growth group only 6 (24%) cases showed exudative recurrence. Treatment response of the growth group worsened after the recurrence in almost half of the patients (N = 11, 44%) and was significantly more frequent than the non-growth group (N = 1, 4%). (PNG 341 kb)

High Resolution Image

(TIF 434 kb)

Supplemental Fig. 2

Schematized diagram between growth group and non-growth group. Schematized diagram shows non-exudative enlargement of lesion on en face optical coherence tomography (OCT) and exudative recurrence of all polypoidal choroidal vasculopathy patients during anti-vascular endothelial growth factor treatment. The gray rectangle represents a visit with exudative findings. The box with the diagonal line indicates the visit that showed non-exudative enlargement of the lesion on the en face OCT image. Of 25 recurrences noted in the study period, 19 (76.0%) had preceding non-exudative enlargement. (PNG 234 kb)

High Resolution Image

(TIF 461 kb)

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Kwon, H.J., Lee, J.J., Park, S.W. et al. Enlargement of polypoidal choroidal vasculopathy lesion without exudative findings assessed in en face optical coherence tomography images. Graefes Arch Clin Exp Ophthalmol 257, 1621–1629 (2019). https://doi.org/10.1007/s00417-019-04317-y

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  • DOI: https://doi.org/10.1007/s00417-019-04317-y

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