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Clinical characteristics of super stable polypoidal choroidal vasculopathy after initial remission with anti-VEGF monotherapy

Authors
 Seonghee Choi  ;  Hae Min Kang  ;  Hyoung Jun Koh 
Citation
 GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, Vol.259(4) : 837-846, 2021-04 
Journal Title
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
ISSN
 0721-832X 
Issue Date
2021-04
MeSH
Angiogenesis Inhibitors / therapeutic use ; Choroid ; Choroidal Neovascularization* / diagnosis ; Choroidal Neovascularization* / drug therapy ; Female ; Fluorescein Angiography ; Humans ; Infant ; Intravitreal Injections ; Polyps* / diagnosis ; Polyps* / drug therapy ; Retrospective Studies ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A
Keywords
Age-related macular degeneration ; Anti-VEGF ; Polypoidal choroidal vasculopathy
Abstract
Purpose: To define a "super stable" subset of polypoidal choroidal vasculopathy (PCV) patients that have a long period of remission following anti-vascular endothelial growth factor (VEGF) therapy.

Methods: Twenty-one eyes that showed no recurrence for over 18 months following anti-VEGF monotherapy were included in the "super stable PCV group" and compared with 37 eyes with recurring disease. Patient demographics, visual acuity, and imaging data from optical coherence tomography (OCT) and fluorescein angiography/indocyanine green angiography were compared between the two groups at baseline and at 3 months after treatment initiation.

Results: The super stable group maintained remission for a mean duration of 31.0 months following a mean of 4.1 anti-VEGF injections. The super stable group was younger at baseline (64.6 ± 8.8 vs. 71.4 ± 7.9 years, P < 0.05) with a higher ratio of females (52.4% vs. 24.3%, P < 0.05) compared with the control group. The super stable group had a higher percentage of eyes with a single polyp, as opposed to multiple polyps (66.7% vs. 32.4%, P < 0.05), and the diameter of the largest polyp was smaller (328.4 ± 98.2 vs. 398.3 ± 112.2 μm, P < 0.05). Baseline choroidal thickness was greater in the super stable group (357 ± 102.7 vs. 293.2 ± 94.6 μm, P < 0.05). At 3 months after treatment, OCT features including central retinal thickness, pigment epithelial detachment (PED) size, and presence of subretinal fluid showed superior response in the super stable group. The reduction in PED height was almost 3 times as large in the super stable group (- 250.1 ± 228.5 μm vs. - 84.4 ± 221.1 μm, P < 0.05). Binary logistic regression further showed that factors such as age, polyp configuration, PED diameter at 3 months, and change in PED height at 3 months were associated with super stable remission.

Conclusion: Identifying super stable PCV patients can prevent overtreatment and lessen treatment burden.
Full Text
https://link.springer.com/article/10.1007/s00417-020-04924-0
DOI
10.1007/s00417-020-04924-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Choi, Seonghee(최성희)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190970
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