scholarly journals Clinical Implications of Pachyvessels in Polypoidal Choroidal Vasculopathy

2019 ◽  
Author(s):  
Nobuo Ijuin ◽  
Hiroki Tsujinaka ◽  
Hiromasa Hirai ◽  
Hironobu Jimura ◽  
Shigeya Nakao ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Enhanced Depth Imaging ◽  
Fundus Photography ◽  
Depth Imaging ◽  
Treatment Naïve ◽  
The Relationship ◽  
Choroidal Vasculopathy ◽  
Fellow Eyes

Abstract Purpose: Polypoidal choroidal vasculopathy (PCV) is one of the disorders within the pachychoroid spectrum diseases. The presence of pachyvessels is one of the characteristics of pachychoroid disorders. However, the relationship between the presence of pachyvessels and the clinical characteristics of PCV eyes has not been determined. The purpose of this study was to determine the relationship between the presence of choroidal pachyvessels and the clinical characteristics of eyes with PCV.Methods: The medical records of patients who were diagnosed with PCV and were treatment-naïve were reviewed. Fluorescein and indocyanine green angiography, fundus photography, spectral domain optical coherence tomography (SD-OCT), and enhanced depth imaging OCT (EDI-OCT) were used to obtain images of the choroid. The PCV eyes were divided into two groups based on the presence or absence of pachyvessels and clinical features and subfoveal choroidal thickness (SFCT) were evaluated between the two groups.Results: Eighty-six eyes of 84 patients with PCV were evaluated. Pachyvessels were detected in 48 eyes (55.8％). The mean SFCT was 203.9 ± 83.9 μm in all 86 eyes, and it was significantly thinner in eyes with pachyvessels (+) than without pachyvessels (-) (183.2 ± 58.4 μm vs 230.2 ± 103.1 μm; P=0.01). The differences in the incidence of subretinal fluid, pigment epithelial detachments, and hemorrhages between the two groups were not significant. However, the PCV eyes in pachyvessels (+) group with hemorrhage had the thinnest choroid (P=0.047). The choroidal features of the fellow eyes were similar to those of the PCV affected eyes, that is, the fellow eyes in pachyvessels (+) group had pachyvessels and the fellow eyes in pachyvessels (-) group did not had pachyvessels. Conclusions: Pachyvessels were presented 55.8% in eyes with PCV, and these eyes had the thin SFCT. The presence of pachyvessels and attenuation of the inner choroid were probably due to the pathological changes in the eyes with PCV.

scholarly journals Clinical Implications of Pachyvessels in Polypoidal Choroidal Vasculopathy

2020 ◽  
Author(s):  
Nobuo Ijuin ◽  
Hiroki Tsujinaka ◽  
Hiromasa Hirai ◽  
Hironobu Jimura ◽  
Shigeya Nakao ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Enhanced Depth Imaging ◽  
Fundus Photography ◽  
Treatment Naïve ◽  
The Relationship ◽  
Choroidal Vessels ◽  
Choroidal Vasculopathy ◽  
Fellow Eyes

Abstract Purpose: Polypoidal choroidal vasculopathy (PCV) is one of the disorders within the pachychoroid spectrum diseases. The presence of pachyvessels is one of the characteristics of pachychoroid disorders. However, the relationship between the presence of pachyvessels and the clinical characteristics of PCV eyes has not been determined. The purpose of this study was to determine the relationship between the presence of choroidal pachyvessels and the clinical characteristics of eyes with PCV. Methods: The medical records of patients who were diagnosed with PCV and were treatment-naïve were reviewed. Fluorescein and indocyanine green angiography, fundus photography, spectral domain optical coherence tomography (SD-OCT), and enhanced depth imaging OCT (EDI-OCT) were used to obtain images of the choroid. The presence of pathologically dilated outer choroidal vessels, pachyvessels, was determined by ICGA images. These pachyvessels were confirmed to correspond with the large choroidal vessels in the EDI OCT images. The PCV eyes were divided into two groups based on the presence or absence of pachyvessels and clinical features and subfoveal choroidal thickness (SFCT) were evaluated between the two groups. Results: Eighty-six eyes of 84 patients with PCV were evaluated. Pachyvessels were detected in 48 eyes (55.8％). The mean SFCT was 203.9 ± 83.9 μm in all 86 eyes, and it was significantly thinner in eyes with pachyvessels (+) than without pachyvessels (-) (183.2 ± 58.4 μm vs 230.2 ± 103.1 μm; P =0.01). The differences in the incidence of subretinal fluid, pigment epithelial detachments, and hemorrhages between the two groups were not significant. However, the PCV eyes in pachyvessels (+) group with hemorrhage had the thinnest choroid ( P =0.047). The choroidal features of the fellow eyes were similar to those of the PCV affected eyes, that is, the fellow eyes in pachyvessels (+) group had pachyvessels and the fellow eyes in pachyvessels (-) group did not have pachyvessels. Conclusions: Pachyvessels were presented 55.8% in eyes with PCV, and these eyes had the thin SFCT. The presence of pachyvessels and attenuation of the inner choroid were probably due to the pathological changes in the eyes with PCV.

scholarly journals Clinical Implications of Pachyvessels in Polypoidal Choroidal Vasculopathy

2020 ◽  
Author(s):  
Nobuo Ijuin ◽  
Hiroki Tsujinaka ◽  
Hiromasa Hirai ◽  
Hironobu Jimura ◽  
Shigeya Nakao ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Enhanced Depth Imaging ◽  
Fundus Photography ◽  
Treatment Naïve ◽  
The Relationship ◽  
Choroidal Vessels ◽  
Choroidal Vasculopathy ◽  
Fellow Eyes

Abstract Purpose: Polypoidal choroidal vasculopathy (PCV) is one of the disorders within the pachychoroid spectrum diseases. The presence of pachyvessels is one of the characteristics of pachychoroid disorders. However, the relationship between the presence of pachyvessels and the clinical characteristics of PCV eyes has not been determined. The purpose of this study was to determine the relationship between the presence of choroidal pachyvessels and the clinical characteristics of eyes with PCV. Methods: The medical records of patients who were diagnosed with PCV and were treatment-naïve were reviewed. Fluorescein and indocyanine green angiography, fundus photography, spectral domain optical coherence tomography (SD-OCT), and enhanced depth imaging OCT (EDI-OCT) were used to obtain images of the choroid. The presence of pathologically dilated outer choroidal vessels, pachyvessels, was determined by ICGA images. These pachyvessels were confirmed to correspond with the large choroidal vessels in the EDI OCT images. The PCV eyes were divided into two groups based on the presence or absence of pachyvessels and clinical features and subfoveal choroidal thickness (SFCT) were evaluated between the two groups. Results: Eighty-six eyes of 84 patients with PCV were evaluated. Pachyvessels were detected in 48 eyes (55.8％). The mean SFCT was 203.9 ± 83.9 μm in all 86 eyes, and it was significantly thinner in eyes with pachyvessels (+) than without pachyvessels (-) (183.2 ± 58.4 μm vs 230.2 ± 103.1 μm; P =0.01). The differences in the incidence of subretinal fluid, pigment epithelial detachments, and hemorrhages between the two groups were not significant. However, the PCV eyes in pachyvessels (+) group with hemorrhage had the thinnest choroid ( P =0.047). The choroidal features of the fellow eyes were similar to those of the PCV affected eyes, that is, the fellow eyes in pachyvessels (+) group had pachyvessels and the fellow eyes in pachyvessels (-) group did not have pachyvessels. Conclusions: Pachyvessels were presented 55.8% in eyes with PCV, and these eyes had the thin SFCT. The presence of pachyvessels and attenuation of the inner choroid were probably due to the pathological changes in the eyes with PCV.

scholarly journals Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy

2018 ◽  
Vol 103 (5) ◽  
pp. 617-622 ◽  
Author(s):  
Manabu Miyata ◽  
Sotaro Ooto ◽  
Kenji Yamashiro ◽  
Hiroshi Tamura ◽  
Masayuki Hata ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Combination Therapy ◽  
Polypoidal Choroidal Vasculopathy ◽  
Fundus Photography ◽  
Combination Group ◽  
Macular Atrophy ◽  
Anti Vegf ◽  
Significant Difference ◽  
Treatment Naïve ◽  
Choroidal Vasculopathy

Background/aimsTo evaluate the 5-year visual and anatomical outcomes after anti-vascular endothelial growth factor (VEGF) therapy alone or in combination with photodynamic therapy (PDT), followed by pro re nata (PRN) anti-VEGF therapy with or without PDT, for polypoidal choroidal vasculopathy (PCV).MethodsThis retrospective, observational study included 61 consecutive patients with treatment-naïve symptomatic PCV who were followed for 5 years. Twenty eyes (20 patients) initially received PDT and intravitreal injection of ranibizumab (IVR), followed by a PRN regimen of anti-VEGF therapy with or without PDT (combination group), while 41 eyes (41 patients) initially received only IVR every 3 months, followed by a PRN regimen of anti-VEGF monotherapy (IVR group). Macular atrophy including the fovea was confirmed using colour fundus photography and spectral-domain optical coherence tomography.ResultsIn both groups, the visual acuity (VA) at 1 year was better than the baseline VA, whereas the 3-year, 4-year and 5-year VA values were similar to the baseline VA. There was no significant difference in the 5-year VA, 5-year central retinal thickness and incidence of macular atrophy between the two groups (p=0.63, 0.72 and 0.06, respectively). In the combination group, the 5-year VA was correlated with the 5-year incidence of macular atrophy (p=0.02, r=0.51).ConclusionsA PRN regimen for PCV may have a limited effect for the long-term maintenance of improved VA. Macular atrophy may occur more frequently with combination therapy and is possibly associated with the 5-year VA. Thus, combination therapy should be carefully selected for patients susceptible to macular atrophy.

Phenotypic and genetic variations between Asian and Caucasian polypoidal choroidal vasculopathy

2020 ◽  
pp. bjophthalmol-2020-317537
Author(s):  
Janice Marie Jordan-Yu ◽  
Kelvin Teo ◽  
Qiao Fan ◽  
Jose Carlos Gana ◽  
Anna Karina Leopando ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Genetic Variations ◽  
Fundus Photography ◽  
Imaging Features ◽  
Nucleotide Polymorphisms ◽  
Asian Patients ◽  
Cohort Differences ◽  
Treatment Naïve ◽  
Lower Ratio ◽  
Choroidal Vasculopathy

PurposeTo compare phenotypic and genetic variations in polypoidal choroidal vasculopathy (PCV) between Caucasian and Asian patients.MethodsWe analysed phenotypic and genotypic data from two sites, Association for Innovation and Biomedical Research on Light and Image, Portugal and Singapore National Eye Centre, Singapore. Baseline fundus photography, spectral domain-optical coherence tomography, indocyanine green and fluorescein angiography scans were analysed by respective reading centres using a standardised grading protocol. Single nucleotide polymorphisms across 8 PCV loci were compared between cases and controls selected from each population.ResultsOne hundred and forty treatment-naïve PCV participants (35 Portuguese and 105 Singaporean) were included. The Portuguese cohort were older (72.33±8.44 vs 68.71±9.40 years, p=0.043) and were comprised of a lower proportion of males (43% vs 71%, p=0.005) compared with the Singaporean cohort. Differences in imaging features include higher prevalence of soft drusen (66% vs 30%, p=0.004), lower prevalence of subretinal haemorrhage (14% vs 67%, p<0.001), smaller polypoidal lesion (PL) area (0.09±0.09 vs 0.76±0.93 mm2, p<0.001), lower ratio of PL to branching vascular network area (3% vs 38%, p<0.001) and lower central retinal thickness (346.48±93.74 vs 493.16±212.92 µm, p<0.001) in the Portuguese cohort. CETP rs3764261 (OR 2.467; 95% CI 1.282 to 4.745, p=0.006) in the Portuguese population was significantly associated with PCV and CFH rs800292 (OR 1.719; 95% CI 1.139 to 2.596, p=0.010) in the Singaporean population, respectively.ConclusionAmong Asian and Caucasian patients with PCV, there are significant differences in the expression of phenotype. We also identified different polymorphisms associated with PCV in the two populations.

POLYPOIDAL CHOROIDAL VASCULOPATHY IN CAUCASIANS: MORPHOLOGICAL FINDINGS FROM MULTIMODAL RETINAL IMAGING

2021 ◽  
Author(s):  
Jorge M. Simão ◽  
Cláudia V. Farinha ◽  
João P. Marques ◽  
Sandrina Nunes ◽  
Isabel M. Pires ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Morphological Features ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Soft Drusen ◽  
The Mean ◽  
Choroidal Vasculopathy ◽  
Sd Oct

Purpose: To characterize the morphological features of polypoidal choroidal vasculopathy (PCV) in a large Caucasian population. Methods: A multicenter, cross-sectional study of treatment-naïve patients with PCV. Baseline fundus photography, spectral-domain optical coherence tomography (SD-OCT), fluorescein and indocyanine green angiography (FA,ICGA) were assessed by trained medical graders. Typical PCV features were explored, and retinal and choroidal thickness (RT,CT) measurements were performed. Results: Seventy-nine eyes of 73 patients (mean age,72.6±11.9 years) were included. ICGA identified macular polyps in 89.9% of cases. SD-OCT revealed mostly subretinal fluid (93.6%) and a retinal pigment epithelium (RPE) detachment in 91.4%, with sharp protrusion in 67.0%. Polyp-like structures were seen in 74.3%, mostly adherent to an elevated RPE (69.6%). Type 1 neovascularization (NV) was identified in 74.7%, while 16.5% had a mixed NV. The mean macular CT was 220.9±83.2 µm (range,67.9-403.6). Diffuse and focal pachychoroid were observed in 26.6% and 30.4%. Soft drusen were reported in 62.0%, but retinal hemorrhage occurred in only 19.0%. Conclusion: The morphological features of PCV in Caucasians are similar to those reported in Asians. Pachychoroid signs were found in nearly half of our cohort. However, the mean age at presentation, high prevalence of soft drusen, and low prevalence of large subretinal hemorrhages make PCV closer to age-related macular degeneration in this ethnic group.

scholarly journals One-year outcomes of fixed-dosing Aflibercept therapy for pre treated and naive polypoidal choroidal vasculopathy patient

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hun Gu Choo ◽  
Jin Hae Lee ◽  
Hyun Sub Oh ◽  
Soon Hyun Kim ◽  
Yong Sung You ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Vision Loss ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Research Information ◽  
Age Related ◽  
Case Series Study ◽  
Treatment Naïve ◽  
One Year ◽  
Choroidal Vasculopathy

Abstract Background Polypoidal choroidal vasculopathy (PCV) is a type of age-related macular degeneration that can cause permanent vision loss. The purpose of this paper was to report the one-year outcomes of fixed-dosing aflibercept therapy for the treatment of PCV. Methods This was a prospective, single-arm, interventional case series study of 25 PCV patients; 12 pre-treated and 13 treatment-naïve patients. The patients were treated and monitored for 12 months. Each patient was administered with an aflibercept (2.0 mg) injection every month for the first 3 months (the loading phase), and thereafter, once every 2 months. At every follow-up visit, best-corrected visual acuity (BCVA) test, fundus examination, and optical coherence tomography for measuring the central subfield macular thickness (CSMT) were performed. Fluorescein and indocyanine green angiography were conducted at baseline and at 4 and 12 months. Results After 12 months of aflibercept therapy, the mean BCVA of the patients significantly improved from 65.48 letters at baseline to 69.91 letters (p=0.001), and the CSMT significantly decreased from 406.92 um at baseline to 276.12 um (p< 0.001). Additionally, ten patients (40%) showed complete polyp regression. The treatment-naïve patients showed a statistically significant improvement in BCVA from 66.58 letters at baseline to 76.36 letters at 12 months, and a significant decrease in CSMT, from 462 to 243 um. In the pre-treated group, there was no change in BCVA (64.46 letters), and the decrease in CSMT from 356.08 to 303.69 um was not statistically significant. Conclusions The fixed-dosing aflibercept regimen is effective for treating patients with PCV and is more effective in treatment-naïve patients than in pre-treated patients. Trial registration Clinical Research Information Service (CRiS), Republic of Korea. Identifer: KCT0005798, Registered: Jan 20, 2021. Retrospectively registered, URL: https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=18546

scholarly journals The implications of subretinal fluid in pachychoroid neovasculopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geun Woo Lee ◽  
Hyeon Cheol Roh ◽  
Se Woong Kang ◽  
A. Young Kim ◽  
Hoon Noh ◽  
...  
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Polypoidal Choroidal Vasculopathy ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Subretinal Fluid ◽  
Longitudinal Changes ◽  
History Of ◽  
Pachychoroid Neovasculopathy ◽  
Choroidal Vasculopathy ◽  
Epidemiological Parameters

AbstractThis study aimed to identify the clinical characteristics and longitudinal changes in exudative pachychoroid neovasculopathy (PNV) and non-exudative PNV. This retrospective cohort study involved 81 eyes of PNV diagnosed by multimodal imaging including optical coherence tomography angiography. At baseline, they were divided into exudative PNV group and non-exudative PNV group depending on the presence of subretinal fluid. The clinical features of both groups and the longitudinal changes were investigated and compared. There were 55 eyes with non-exudative PNV and 26 eyes with exudative PNV. Individuals with non-exudative PNV were older, more frequently asymptomatic and had a higher prevalence of polypoidal choroidal vasculopathy in the opposite eye (all P’s < 0.05). Whereas individuals with exudative PNV showed thicker choroid and more frequent history of central serous chorioretinopathy (all P’s < 0.001). During about 12 months of longitudinal observation, the transformation into polypoidal choroidal vasculopathy was noted in 4 eyes of non-exudative PNV group, whereas in none of the exudative PNV group. Exudative PNV and non-exudative PNV seem to be separate entities with different epidemiological parameters. Non-exudative PNV, which is frequently found without symptoms at an older age, is suspected to be the significant precursor lesion of polypoidal choroidal vasculopathy. In contrast, exudative PNV may share the same pathophysiology as central serous chorioretinopathy.

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