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Subfoveal choroidal thickness as a predictor of treatment response to anti-vascular endothelial growth factor therapy for polypoidal choroidal vasculopathy

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To investigate whether subfoveal choroidal thickness predicted treatment response to anti-vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV).

Methods

This retrospective observational case series included 66 eyes of 60 patients who were diagnosed with new-onset PCV and who were followed for a minimum of 6 months. Patients received three monthly intravitreal injections of 0.5 mg ranibizumab or 1.25 mg bevacizumab, at baseline, month 1, and month 2. “Good responders” were defined as those who showed complete resolution of subretinal and/or intraretinal fluid at month 3 after the loading injections, whereas “poor responders” were defined as those who showed persistent retinal fluid on optical coherence tomography (OCT) at month 3 after treatment. Differences in best-corrected visual acuity, indocyanine green angiography, and spectral domain-OCT findings at baseline were analyzed between the two groups.

Results

The mean patient age was 68.2 ± 9.7 years, and the mean follow-up period was 27 ± 21 months. The mean subfoveal choroidal thickness was 273 ± 117 μm, and choroidal vascular hyperpermeability was observed in 35 eyes (53.0 %). Thirty-three eyes (50 %) showed good response to treatment, and a thinner subfoveal choroid at baseline significantly correlated with favorable treatment response (P = 0.024). However, there was no significant relationship between treatment response and choroidal vascular hyperpermeability (P = 0.999).

Conclusions

The subfoveal choroid was found to be significantly thinner among patients who achieved complete resolution of macular exudation after three loading injections of anti-VEGF agents.

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References

  1. Yannuzzi LA, Sorenson J, Spaide RF, Lipson B (1990) Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina 10(1):1–8

    Article  CAS  PubMed  Google Scholar 

  2. Imamura Y, Engelbert M, Iida T, Freund KB, Yannuzzi LA (2010) Polypoidal choroidal vasculopathy: a review. Surv Ophthalmol 55(6):501–515

    Article  PubMed  Google Scholar 

  3. Tamura H, Tsujikawa A, Otani A et al (2007) Polypoidal choroidal vasculopathy appearing as classic choroidal neovascularisation on fluorescein angiography. Br J Ophthalmol 91(9):1152–1159

    Article  PubMed  PubMed Central  Google Scholar 

  4. Laude A, Cackett PD, Vithana EN et al (2010) Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease? Prog Retin Eye Res 29(1):19–29

    Article  PubMed  Google Scholar 

  5. Sasahara M, Tsujikawa A, Musashi K et al (2006) Polypoidal choroidal vasculopathy with choroidal vascular hyperpermeability. Am J Ophthalmol 142(4):601–607

    Article  PubMed  Google Scholar 

  6. Jirarattanasopa P, Ooto S, Nakata I et al (2012) Choroidal thickness, vascular hyperpermeability, and complement factor H in age-related macular degeneration and polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci 53(7):3663–3672

    Article  CAS  PubMed  Google Scholar 

  7. Sonoda S, Sakamoto T, Otsuka H et al (2013) Responsiveness of eyes with polypoidal choroidal vasculopathy with choroidal hyperpermeability to intravitreal ranibizumab. BMC Ophthalmol 13:43

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chung SE, Kang SW, Lee JH, Kim YT (2011) Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration. Ophthalmology 118(5):840–845

    Article  PubMed  Google Scholar 

  9. Koizumi H, Yamagishi T, Yamazaki T, Kawasaki R, Kinoshita S (2011) Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 249(8):1123–1128

    Article  PubMed  Google Scholar 

  10. Nishide T, Hayakawa N, Nakanishi M et al (2013) Reduction in choroidal thickness of macular area in polypoidal choroidal vasculopathy patients after intravitreal ranibizumab therapy. Graefes Arch Clin Exp Ophthalmol 251(10):2415–2420

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Maruko I, Iida T, Oyamada H, Sugano Y, Ojima A, Sekiryu T (2013) Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy. Am J Ophthalmol 156(3):548–556

    Article  CAS  PubMed  Google Scholar 

  12. Kang HM, Koh HJ (2013) Long-term visual outcome and prognostic factors after intravitreal ranibizumab injections for polypoidal choroidal vasculopathy. Am J Ophthalmol 156(4):652–660

    Article  PubMed  Google Scholar 

  13. Hikichi T, Higuchi M, Matsushita T et al (2012) One-year results of three monthly ranibizumab injections and as-needed reinjections for polypoidal choroidal vasculopathy in Japanese patients. Am J Ophthalmol 154(1):117–124, e111

    Article  CAS  PubMed  Google Scholar 

  14. Saito M, Iida T, Kano M (2011) Intravitreal ranibizumab for polypoidal choroidal vasculopathy with recurrent or residual exudation. Retina 31(8):1589–1597

    Article  CAS  PubMed  Google Scholar 

  15. Hirami Y, Tsujikawa A, Otani A et al (2007) Hemorrhagic complications after photodynamic therapy for polypoidal choroidal vasculopathy. Retina 27(3):335–341

    Article  PubMed  Google Scholar 

  16. Matsumiya W, Honda S, Kusuhara S, Tsukahara Y, Negi A (2013) Effectiveness of intravitreal ranibizumab in exudative age-related macular degeneration (AMD): comparison between typical neovascular AMD and polypoidal choroidal vasculopathy over a 1 year follow-up. BMC Ophthalmol 13:10

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Hikichi T, Ohtsuka H, Higuchi M et al (2010) Improvement of angiographic findings of polypoidal choroidal vasculopathy after intravitreal injection of ranibizumab monthly for 3 months. Am J Ophthalmol 150(5):674–682, e671

    Article  CAS  PubMed  Google Scholar 

  18. Nowak-Sliwinska P, van den Bergh H, Sickenberg M, Koh AH (2013) Photodynamic therapy for polypoidal choroidal vasculopathy. Prog Retin Eye Res 37:182–199

    Article  PubMed  Google Scholar 

  19. Kang HM, Kim YM, Koh HJ (2013) Five-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 155(3):438–447, e431

    Article  PubMed  Google Scholar 

  20. Cho HJ, Kim HS, Jang YS et al (2013) Effects of choroidal vascular hyperpermeability on anti-vascular endothelial growth factor treatment for polypoidal choroidal vasculopathy. Am J Ophthalmol 156(6):1192–1200, e1191

    Article  CAS  PubMed  Google Scholar 

  21. Koizumi H, Yamagishi T, Yamazaki T, Kinoshita S (2013) Relationship between clinical characteristics of polypoidal choroidal vasculopathy and choroidal vascular hyperpermeability. Am J Ophthalmol 155(2):305–313, e301

    Article  PubMed  Google Scholar 

  22. Koh A, Lee WK, Chen LJ et al (2012) EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina 32(8):1453–1464

    Article  CAS  PubMed  Google Scholar 

  23. Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7 (1991) Ophthalmology 98(5 Suppl):741–756

  24. Spaide RF, Koizumi H, Pozzoni MC (2008) Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 146(4):496–500

    Article  PubMed  Google Scholar 

  25. Kang HM, Kwon HJ, Yi JH, Lee CS, Lee SC (2014) Subfoveal choroidal thickness as a potential predictor of visual outcome and treatment response after intravitreal ranibizumab injections for typical exudative age-related macular degeneration. Am J Ophthalmol 157(5):1013–1021

    Article  PubMed  Google Scholar 

  26. Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF (2010) Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology 117(9):1792–1799

    Article  PubMed  Google Scholar 

  27. Park HS, Kim IT (2012) Clinical characteristics of polypoidal choroidal vasculopathy associated with chronic central serous chorioretionopathy. Korean J Ophthalmol 26(1):15–20

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ueta T, Obata R, Inoue Y et al (2009) Background comparison of typical age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology 116(12):2400–2406

    Article  PubMed  Google Scholar 

  29. Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, Martin DF, Maguire MG, Fine SL et al (2012) Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results. Ophthalmology 119(7):1388–1398

    Article  Google Scholar 

  30. Usui S, Ikuno Y, Akiba M et al (2012) Circadian changes in subfoveal choroidal thickness and the relationship with circulatory factors in healthy subjects. Invest Ophthalmol Vis Sci 53:2300–2307

    Article  PubMed  Google Scholar 

  31. Lee SW, Yu SY, Seo KH, Kim ES, Kwak HW (2014) Diurnal variation in choroidal thickness in relation to sex, axial length, and baseline choroidal thickness in healthy Korean subjects. Retina 34(2):385–393

    Article  PubMed  Google Scholar 

  32. Han YS, Lim HB, Lee SH, Kim JY (2015) Diurnal Variation in Choroidal and Retinal Thickness of the Early Treatment of Diabetic Retinopathy Study Macular Subfields Determined Using Swept-Source Optical Coherence Tomography. Ophthalmologica 233:192–197

    Article  PubMed  Google Scholar 

  33. Tan CS, Ouyang Y, Ruiz H, Sadda SR (2012) Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci 53:261–266

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. The Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea

    Hyesun Kim, Sung Chul Lee, Kye Yoon Kwon, Ji Hwan Lee, Hyoung Jun Koh, Suk Ho Byeon, Sung Soo Kim, Min Kim & Christopher Seungkyu Lee

  2. Siloam Eye Hospital, Seoul, Korea

    Hyesun Kim

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  1. Hyesun Kim
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  2. Sung Chul Lee
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  4. Ji Hwan Lee
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Correspondence to Christopher Seungkyu Lee.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Kim, H., Lee, S.C., Kwon, K.Y. et al. Subfoveal choroidal thickness as a predictor of treatment response to anti-vascular endothelial growth factor therapy for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 254, 1497–1503 (2016). https://doi.org/10.1007/s00417-015-3221-x

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  • DOI: https://doi.org/10.1007/s00417-015-3221-x

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