| 1 Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea
2 Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea
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| Jiwon Baek, MD., PhD.1, Jae Hyung Lee, MD., PhD.2, Lee Kook, MD.2, Byung Joo Chung, MD.2, Won Ki Lee, MD., PhD.2 |
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Purpose : To determine the impact of choroidal vascular morphology of large vessel layer on clinical outcomes in patients with polypoidal choroidal vasculopathy (PCV)/ aneurysmal type 1 (AT1) neovascularization.
Methods : A retrospective cohort study. Sixty-six eyes with PCV/AT1 were subdivided according to choroidal vascular morphology of large vessel layer on OCT en face images: focal (n=39) vs. diffuse (n=27) pachyvessels. All patients were treated with intravitreal ranibizumab pro re nata with or without rescue photodynamic therapy (PDT) during at least 12 months follow-up period. Functional and anatomical outcomes and response to treatments were compared between groups.
Results : Age was older (71.1 vs. 66.8 years, P = .008), choroid was thinner (189.3 vs. 355.1 µm, P < .001), and choroidal hyperpermeability was less frequent (13% vs. 52%, P = .001) in focal group. The mean best-corrected visual acuity (BCVA) at baseline, 6, and 12 months did not differ between groups (.48, .41, and .39 in focal group vs. .40, .29, and .30 in diffuse group, respectively. P = .394, .142, and .292). At month 3, BCVA was worse (.49 vs. .29, P = .016) and proportion of eyes with fluid was higher (62% vs. 33%, P = .024) in focal group. Among responders, number of injections during 12-months follow-up period was higher in focal group (6.14 vs 4.86, P = .033). During total follow-up period (51.9 and 48.0 months in focal and diffuse group, respectively, P = .489), PDT was required in 15 eyes (10 and 5 in focal and diffuse group, respectively, P = .497). Injection-free period after the PDT was shorter in focal group (7.0 vs. 23.6 months, P = 0.018).
Conclusion : PCV/AT1 eyes with diffuse pattern of pachyvessels required less injections during the 12 months follow-up period and showed longer injection-free period after rescue PDT.
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