Clinical characteristics of super stable polypoidal choroidal vasculopathy after initial remission with anti-VEGF monoth
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Clinical characteristics of super stable polypoidal choroidal vasculopathy after initial remission with anti-VEGF monotherapy Seonghee Choi 1 & Hae Min Kang 2 & Hyoung Jun Koh 1 Received: 10 May 2020 / Revised: 28 August 2020 / Accepted: 5 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
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 antiVEGF 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. Keywords Age-related macular degeneration . Anti-VEGF . Polypoidal choroidal vasculopathy
This manuscript was presented as an original paper at the 43rd Macular Society Meeting in February 2020. This material was also partly presented as a poster at the 2019 American Academy of Ophthalmology Annual Meeting in San Francisco. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00417-020-04924-0) contains supplementary material, which is available to authorized users. * Hyoung Jun Koh [email protected] 1
Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2
Department of Ophthalmology, International St. Mary’s Hospital, Catholic Kwandong Univers
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