Comparison of progression to advanced stage between polypoidal choroidal vasculopathy and age-related macular degeneration in South Korea

Abstract

Objective: To compare risk factors and progression rate to advanced stage in typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) in South Korea.

Design: Retrospective study, observational, consecutive case series.

Participants: 365 patients with unilateral advanced stage AMD (222 typical AMD patients and 143 PCV patients).

Methods: All patients underwent fundus photography (FP), fluorescence angiography (FA), and indocyanine green angiography (ICGA) at initial presentation. Age-Related Eye Disease Study (AREDS) score was measured at initial presentation. The rate of progression to advanced stage AMD in the fellow eye was compared between the typical AMD and PCV based on the initial AREDS score (range, 2 to 4).

Main Outcome Measures: Rate of progression to advanced stage in the fellow eye based on initial AREDS score and the correlation between the initial AREDS score and progression to advanced AMD of the fellow eye according to types of AMD.

Results: Progression to advanced AMD in fellow eye was similar between the typical AMD and PCV groups (14.0% vs. 17.0%, respectively, log rank test, z=1, p=0.528). At baseline, PCV group was younger than the typical AMD group with lower AREDS score compared to the typical AMD group. Among patients with initial AREDS score=2 (normal macula or small drusen on the fellow eye), a higher proportion of PCV patients progressed to advanced AMD than typical AMD patients (9.6% vs. 2.2%, respectively, log rank test, z=1, p<0.001). Initial AREDS score was significantly associated with progression to advanced stage of fellow eye in the typical AMD group, after adjusting for age, gender, and other co-morbidities (odds ratio [OR]=3.708; 95% confidence interval [CI]:1.511-9.102, p=0.004). However in PCV group, initial AREDS score was not associated with progression to advanced stage of fellow eye. (OR=1.885; 95% CI: 0.791-4.492, p=0.055).

Conclusions: Unlike typical AMD, PCV could progress without any typical sign of early AMD. Also, initial AREDS score was not associated with the progression to advanced stage in PCV in contrast to typical AMD.