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TYPICAL POLYPOIDAL CHOROIDAL VASCULOPATHY AND POLYPOIDAL CHOROIDAL NEOVASCULARIZATION

Jang, Jun Won MD; Kim, Jong Min MD; Kang, Se Woong MD, PhD; Kim, Sang Jin MD, PhD; Bae, Kunho MD; Kim, Kyung Tae MD

doi: 10.1097/IAE.0000000000002259
Original Study
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Purpose: To compare typical polypoidal choroidal vasculopathy (T-PCV) and polypoidal choroidal neovascularization (P-CNV), which can be defined as two subtypes of PCV, and to elucidate the significance of the classification.

Methods: Seventy-seven patients diagnosed with PCV and followed up for more than 12 months were reviewed. The PCV cases were divided into a T-PCV group (n = 36) and a P-CNV group (n = 41) according to the presence of features of pachychoroid or age-related macular degeneration. Angiographic and tomographic characteristics and changes in vision during the follow-up period were compared between the two groups.

Results: Logarithm of the minimum angle of resolution visual acuity of T-PCV and P-CNV was 0.27 ± 0.31 and 0.62 ± 0.47 at baseline (P < 0.001) and 0.28 ± 0.41 and 0.54 ± 0.52 at the final visit (P = 0.006), respectively. A marginally higher rate of complete response to anti–vascular endothelial growth factor treatment was noted in the T-PCV group (47.2%) compared with the P-CNV group (26.8%) (P = 0.05). At the final visit, subfoveal fibrosis was noted in 11.1% of the T-PCV group and 39.0% of the P-CNV group (P = 0.009).

Conclusion: The two subtypes of PCV, P-CNV and T-PCV, behave differently in terms of angiographic and tomographic manifestations and visual outcomes. Classifying PCVs would be helpful not only for pathogenic implications, but also for prognostic significance.

Polypoidal choroidal vasculopathy can be classified into two subtypes: typical polypoidal choroidal vasculopathy and polypoidal choroidal neovascularization. Polypoidal choroidal neovascularization had worse initial and final visual acuity. Final visual acuity in the eyes with polypoidal choroidal neovascularization might be affected by poorer treatment response and development of subretinal fibrosis.

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Reprint requests: Se Woong Kang, MD, PhD, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea; e-mail: swkang@skku.edu

None of the authors has any financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.