Seonghee Choi1, Hae Min Kang2, Hyoung Jun Koh3. 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 University College of Medicine, Incheon, Republic of Korea. 3. Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. HJKOH@yuhs.ac.
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.
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.
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