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Visual Prognosis in the Better-seeing Eyes of Patients with Unilateral Polypoidal Choroidal Vasculopathy

Kim, Jae Hui MD1*; Kim, Jong Woo MD1; Kim, Chul Gu MD1; Lee, Dong Won MD1

doi: 10.1097/OPX.0000000000001419
ORIGINAL INVESTIGATIONS
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SIGNIFICANCE In patients initially diagnosed as having unilateral polypoidal choroidal vasculopathy, the visual prognosis of the better-seeing eye is highly favorable. If patients are overly pessimistic regarding their vision in the future, physicians can encourage patients by informing them of the small possibility for visual deterioration in the better-seeing eye.

PURPOSE The purpose of this study was to investigate the long-term changes in the visual acuity of the better-seeing eyes in patients with unilateral polypoidal choroidal vasculopathy.

METHODS This retrospective, single-institution study was performed with 221 patients who were diagnosed as having unilateral polypoidal choroidal vasculopathy and who were treated with intravitreal anti–vascular endothelial growth factor. Only patients with an initially uninvolved eye best-corrected visual acuity (BCVA) of 20/40 or better and who were followed up for at least 24 months were included. The changes in the BCVAs of the initially involved and uninvolved eyes as well as the better-seeing eyes were measured. For patients with three or more lines of uninvolved eye visual deterioration, the cause for the visual deterioration was identified.

RESULTS Patients were followed up for a mean of 43.1 ± 11.8 months after diagnosis. During the follow-up period, three or more lines of deterioration in the BCVA were noted in 61 initially involved eyes (27.6%) and 11 uninvolved eyes (4.9%). The reasons for uninvolved eye visual deterioration were neovascularization (n = 8), retinal vein occlusion (n = 2), and posterior capsule opacification (n = 1). At diagnosis, the BCVA of the better-seeing eye was 0.05 ± 0.08 (Snellen equivalents, 20/22). During the follow-up period, three or more lines of deterioration in the BCVA for the better-seeing eye were noted in eight patients (3.6%).

CONCLUSIONS Visual acuity of the better-seeing eye over time remained stable in most patients who were initially diagnosed as having unilateral polypoidal choroidal vasculopathy. As a result, the visual prognosis of the better-seeing eye is highly favorable in this condition.

1Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea

*kimoph@gmail.com

Submitted: December 20, 2018

Accepted: May 21, 2019

Funding/Support: None of the authors have reported funding/support.

Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest.

Author Contributions: Conceptualization: JHK; Data Curation: JHK, JWK, CGK, DWL; Formal Analysis: JHK, JWK, CGK, DWL; Funding Acquisition: JHK; Investigation: JHK, JWK; Methodology: JHK; Project Administration: JHK; Resources: JHK, JWK, CGK, DWL; Software: JHK; Supervision: JHK, JWK; Validation: JHK; Visualization: JHK; Writing – Original Draft: JHK; Writing – Review & Editing: JHK, JWK, CGK, DWL.

© 2019 American Academy of Optometry