Korean J Ophthalmol.  2016 Aug;30(4):272-279. 10.3341/kjo.2016.30.4.272.

Intravitreal Anti-vascular Endothelial Growth Factor for Treating Polypoidal Choroidal Vasculopathy with Grape-like Polyp Clusters

• Chang YS
• Kim JH
• Kim JW
• Lee TG
• Kim CG

• KMID: 2373987
• DOI: http://doi.org/10.3341/kjo.2016.30.4.272

Abstract

PURPOSE
To evaluate 12-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with grape-like polyp clusters.
METHODS
This retrospective observational study included 23 eyes of 23 patients who were newly diagnosed with PCV with grape-like polyp clusters, and who were subsequently treated with anti-VEGF monotherapy. The study compares the best-corrected visual acuity (BCVA) of the patients at diagnosis, at 3 months, and at 12 months after diagnosis. In addition, 12-month changes in BCVA values were compared between cases with subfoveal or juxtafoveal polyps and cases with extrafoveal polyps.
RESULTS
The baseline, 3-month, and 12-month logarithm of the minimal angle of resolution BCVA was 0.62 ± 0.35, 0.50 ± 0.43, and 0.58 ± 0.48, respectively. Compared to the baseline, patient BCVA was not significantly different at 12 months after diagnosis (p = 0.764). Six eyes (26.1%) gained ≥0.2 logarithm of the minimal angle of resolution BCVA. In cases with subfoveal or juxtafoveal polyps, BCVA values at baseline and at 12 months after diagnosis were 0.66 ± 0.37 and 0.69 ± 0.53, respectively. In cases with extrafoveal polyps, the values were 0.54 ± 0.33 and 0.37 ± 0.31, respectively. Changes in BCVA values were significantly different between the two groups (p = 0.023).
CONCLUSIONS
Although anti-VEGF therapy has favorable short-term efficacy for treating PCV with grape-like polyp clusters, long-term visual improvements are generally limited in the majority of afflicted eyes. The presence of subfoveal or juxtafoveal polyps may suggest unfavorable treatment outcomes.

Keyword

Age-related macular degeneration; Anti-vascular endothelial growth factor; Choroidal neovascularization; Polypoidal choroidal vasculopathy

MeSH Terms

Aged
Angiogenesis Inhibitors/*administration & dosage
Choroid/blood supply/*diagnostic imaging
Choroidal Neovascularization/diagnosis/*drug therapy
Female
Fluorescein Angiography
Follow-Up Studies
Fundus Oculi
Humans
Intravitreal Injections
Male
Polyps/diagnosis/*drug therapy
Retrospective Studies
Tomography, Optical Coherence
Vascular Endothelial Growth Factor A/*antagonists & inhibitors
Angiogenesis Inhibitors
Vascular Endothelial Growth Factor A

Figure

• 

  Fig. 1 Indocyanine green angiography images (A,B) from eyes diagnosed with polypoidal choroidal vasculopathy with grape-like polyp clusters.

• 

  Fig. 2 Changes in the mean logarithm of minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) (A) and central foveal thickness (B) in eyes diagnosed with polypoidal choroidal vasculopathy with grape-like polyp clusters. Statistical analyses were performed using repeated measures analysis of variances with the Bonferroni correction.

• 

  Fig. 3 Fundus photography (A), fluorescein angiography (B), indocyanine green angiography (C), and optical coherence tomography (D,E) images at diagnosis (A-D) and at 12 months (E) from diagnosis in an eye with polypoidal choroidal vasculopathy with grape-like polyp clusters (arrow, C). In this case, the polyps were located at the fovea. Subretinal fluid was observed at 12 months after diagnosis (E).

• 

  Fig. 4 Fundus photography (A), fluorescein angiography (B), indocyanine green angiography (C), and optical coherence tomography (D,E) images at diagnosis (A-D) and at 12 months (E) from diagnosis in an eye with polypoidal choroidal vasculopathy with grape-like polyp clusters (arrow, C). In this case, the polyps were located outside the fovea. At 12 months after diagnosis (E), complete resolution of the fluid was noted.

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