Nonexudative branching vascular network (BVN) growth and progression of polypoidal lesions are associated with exudative recurrences in polypoidal choroidal vasculopathy (PCV), according to research published in Ophthalmology. The study also shows that progression of polypoidal lesions could serve as a stand-alone indicator for near-term onset of exudation.
The study included patients with PCV receiving anti-vascular endothelial growth factor (VEGF) monotherapy or anti-VEGF plus photodynamic therapy (PDT) who were followed for at least 1 year.
The researchers divided the patients into 2 groups based on whether exudative recurrence occurred during follow-up. They collected and compared multiple parameters between the groups, including age, gender, best-corrected visual acuity (BCVA), number of polypoidal lesions, lesion area at the first swept-source optical coherence tomography angiography (SS-OCT-A) imaging visit, and total lesion area change from the first SS-OCTA visit to the last SS-OCT-A visit.
The team evaluated the association between SS-OCT-A imaging-based risk factors and the exudative recurrences at each follow-up visit. In cases with exudative recurrence, they assessed the time intervals from the nonexudative visit with lesion progression to the corresponding exudative recurrence visit.
A total of 31 eyes of 31 patients (61% men and 39% women), with a mean age of 68.16±5.61 years, were included in the study. For an average follow-up duration of 20.55±6.86 months, 15 eyes had exudative recurrence, and 16 eyes had no recurrence.
The researchers found that the recurrence group had worse median BCVA (0.22 vs 0.52 logMAR; P =.019), and a greater increase in lesion area (0.82 vs 0.03 mm2; P =.010) than the no-recurrence group at the last visit.
The team found that the median time interval between BVN growth and recurrence was longer than that between polypoidal lesion progression and recurrence (7 vs 3 months; P =.009). Using logistic regression analysis, they demonstrated that polypoidal lesion progression and BVN growth were associated with exudative recurrences within 3 months (polypoidal lesion progression: OR, 26.67; 95% confidence interval [CI], 3.77-188.54; P =.001; BVN growth: OR, 0.573; 95% CI, 0.08-4.01; P =.573).
“Compared with BVN growth, polypoidal lesion progression was more commonly associated with exudative recurrence,” according to the researchers.
The investigators recommend more frequent follow-up visits when polypoidal lesions show progression in PCV.
Limitations of the study included the retrospective design, relatively small sample size, and treatment of patients with both PDT and anti-VEGF therapy.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Bo Q, Zhang M, Chen J, et al. Progression of polypoidal lesions associated with exudative recurrence in polypoidal choroidal vasculopathy. Ophthalmol. 2022;S0161-6420(22)00748-5. doi:10.1016/j.ophtha.2022.09.013