Colin S H Tan1, Wei Kiong Ngo2, Louis W Lim2, Tock Han Lim1. 1. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore. 2. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Abstract
PURPOSE: To propose a novel classification system for polypoidal choroidal vasculopathy (PCV), and compare the clinical outcomes among PCV subtypes. METHODS: Consecutive treatment-naive patients with symptomatic PCV were managed over 5 years. PCV subtypes were classified based on indocyanine green angiography (ICGA) and fluorescein angiography (FA) characteristics. RESULTS: Among 107 patients, 3 PCV subtypes were seen: Type A (interconnecting channels on ICGA) -22.4%; Type B (branching vascular network with no leakage) -24.3%; Type C (branching vascular network with late leakage on FA) -53.3%. The proportion of patients with best-corrected visual acuity (BCVA) ≥20/40 was highest in Type A, intermediate in Type B and lowest in Type C at all time points (80% vs 66.7% vs 7.7% at 5 years, p<0.001). The highest rate of moderate visual loss (loss of ≥3 lines) occurred in Type C PCV (57.7% vs 0% for Types B and A at 5 years, p<0.001). Risk factors for poor visual outcomes were PCV subtype (OR 53.7, p<0.001 for Type C and OR 13.7, p=0.023 for Type B compared to Type A) and age (OR 1.06, 95% CI 1.002 to 1.125, p=0.044). CONCLUSIONS: The PCV subtype seen on initial presentation affects the long-term visual outcomes over a 5-year period. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
PURPOSE: To propose a novel classification system for polypoidal choroidal vasculopathy (PCV), and compare the clinical outcomes among PCV subtypes. METHODS: Consecutive treatment-naive patients with symptomatic PCV were managed over 5 years. PCV subtypes were classified based on indocyanine green angiography (ICGA) and fluorescein angiography (FA) characteristics. RESULTS: Among 107 patients, 3 PCV subtypes were seen: Type A (interconnecting channels on ICGA) -22.4%; Type B (branching vascular network with no leakage) -24.3%; Type C (branching vascular network with late leakage on FA) -53.3%. The proportion of patients with best-corrected visual acuity (BCVA) ≥20/40 was highest in Type A, intermediate in Type B and lowest in Type C at all time points (80% vs 66.7% vs 7.7% at 5 years, p<0.001). The highest rate of moderate visual loss (loss of ≥3 lines) occurred in Type C PCV (57.7% vs 0% for Types B and A at 5 years, p<0.001). Risk factors for poor visual outcomes were PCV subtype (OR 53.7, p<0.001 for Type C and OR 13.7, p=0.023 for Type B compared to Type A) and age (OR 1.06, 95% CI 1.002 to 1.125, p=0.044). CONCLUSIONS: The PCV subtype seen on initial presentation affects the long-term visual outcomes over a 5-year period. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.