Korean J Ophthalmol.  2017 Oct;31(5):431-438. 10.3341/kjo.2016.0101.

Peripapillary Choroidal Thickness Change of Polypoidal Choroidal Vasculopathy after Anti-vascular Endothelial Growth Factor

Affiliations
  • 1Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. hjkoh@yuhs.ac

Abstract

PURPOSE
To investigate the peripapillary choroidal thickness (PCT) of polypoidal choroidal vasculopathy (PCV) and exudative age-related macular degeneration (AMD) and to evaluate their responses to anti-vascular endothelial growth factor (VEGF).
METHODS
Thirty eyes with PCV and 25 eyes with exudative AMD who were treatment naïve were included in this study. PCT and subfoveal choroidal thickness were evaluated both before and after intravitreal anti-VEGF.
RESULTS
The initial mean PCT of PCV (153.78 ± 56.23 µm) was thicker than that of exudative AMD (88.77 ± 23.11 µm, p < 0.001). Temporal, superior, nasal, and inferior PCTs of PCV were all thicker than those observedin exudative AMD (all p < 0.05). After anti-VEGF, the mean PCT of PCV was significantly reduced (134.17 ± 41.66 µm, p < 0.001), but the same was not true not in exudative AMD (86.87 ± 22.54 µm, p = 0.392). PCTshowed a similar tendency in all quadrants.
CONCLUSIONS
PCV exhibits a thick choroid in the peripapillary region. PCT decreases after anti-VEGF in PCV but not in exudative AMD. In exudative AMD, subfoveal choroidal thickness decreased, but that in the peripapillary region did not.

Keyword

Anti-vascular endothelial growth factor; Choroid; Macular degeneration; Polypoidal choroidal vasculopathy

MeSH Terms

Choroid*
Endothelial Growth Factors*
Macular Degeneration
Endothelial Growth Factors

Figure

  • Fig. 1 Measurement of peripapillary choroidal thickness and subfoveal choroidal thickness. (A) Fundus photography of a 56-year-old female with polypoidal choroidal vasculopathy. (B,D) We measured the peripapillary choroidal thickness by subtracting the retinal thickness (D) from the chorioretinal thickness obtained by manual modification of the retinal pigment epithelium line (B). (C) A 360° 3.4-mm-diameter circle scan around the disc was performed to obtain the retinal and choroidal thickness. (E) Horizontal scan line of fundus. (F) Subfoveal choroidal thickness. ILM = internal limiting membrane; SC = sclerochoroidal junction; T = temporal; S = superior, N = nasal; I = inferior; BM = Bruch's membrane.

  • Fig. 2 A representative case of the change in peripapillary choroidal thickness (PCT) following administration of anti-vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV) and exudative age-related macular degeneration (AMD). (A-F) A 70-year-old female with PCV. (B,C) The subfoveal choroidal thickness decreased from 407 µm to 303 µm. (E,F) The mean PCT was 198 µm and decreased to 150 µm after anti-VEGF administration (25%). (G-L) A 77-year-old female with exudative AMD. (H,I) The subfoveal choroidal thickness decreased from 190 µm to 175 µm (K,L). The mean PCT values were 119 µm before and 114 µm after anti-VEGF.

  • Fig. 3 Change in peripapillary choroidal thickness (PCT) in polypoidal choroidal vasculopathy (PCV) and exudative age-related macular degeneration (AMD). The PCT of PCV was thicker than that of exudative AMD both before and after anti-vascular endothelial growth factor (VEGF) was administered. PCT decreased after anti-VEGF in PCV (*p < 0.022) but not in exudative AMD. Inferior PCT was thinnest in both PCV and exudative AMD both before and after anti-VEGF. †p < 0.018 with post hoc analysis between the sectors of PCV before treatment; ‡p < 0.014 with post hoc analysis between the sectors of exudative AMD before anti-VEGF.


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