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Kim, Jae Hui, MD*; Chang, Young Suk, MD; Kim, Jong Woo, MD*; Kim, Chul Gu, MD*; Lee, Dong Won, MD*; Kim, Ye Ji, MD*

doi: 10.1097/IAE.0000000000001845
Original Study

Purpose: To investigate morphologic features associated with fibrotic scarring after anti–vascular endothelial growth factor therapy in polypoidal choroidal vasculopathy (PCV).

Methods: This retrospective study included 293 patients who had been diagnosed with PCV and treated with anti-vascular endothelial growth factor monotherapy during a 12-month follow-up period. Associations of morphologic features, including type of PCV, location of the polypoidal lesion, greatest linear dimension, largest polyp diameter, choroidal vascular hyperpermeability, pigment epithelial detachment, intraretinal fluid, and subretinal hyperreflective material (SHRM) with fibrotic scar at 12 months were analyzed.

Results: Fibrotic scars were noted in 15 eyes (5.1%). The incidence of fibrotic scars was higher in Type 1 PCV (8 of 76 eyes) than in Type 2 PCV (7 of 217 eyes, P = 0.028). The incidence was also higher in eyes with SHRM (14 of 124 eyes) than in eyes without SHRM (1 of 169 eyes, P < 0.001). In multivariate analysis, SHRM was associated with fibrotic scar (P = 0.005). Among the SHRM cases, the incidence of the scar was 12.9% in eyes with submacular hemorrhage and 8.5% in eyes without hemorrhage.

Conclusion: Although fibrotic scar is an infrequent finding in PCV, the possibility of scarring should be considered in eyes with SHRM, particularly in submacular hemorrhage cases.

The 12-month incidence of fibrotic scar involving the fovea was 5.1% in patients with polypoidal choroidal vasculopathy who were treated with anti–vascular endothelial growth factor. Subretinal hyperreflective material was the most significantly associated morphologic feature with fibrotic scarring, particularly in submacular hemorrhage cases.

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

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea.

Reprint requests: Jae Hui Kim, MD, Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul 150-034, South Korea; e-mail:

Supported by Kim's Eye Hospital Research Center.

None of the authors has any conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.