CHOROIDAL VASCULAR HYPERPERMEABILITY AS A PREDICTOR OF TREATMENT RESPONSE FOR POLYPOIDAL CHOROIDAL VASCULOPATHY

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Polypoidal choroidal vasculopathy (PCV) is a common cause of wet age-related macular degeneration.
• Treatment outcomes for PCV can vary significantly between patients.
• Identifying predictive biomarkers is crucial for personalized treatment strategies.

Purpose of the Study:

• To assess the impact of choroidal vascular hyperpermeability (CVH) and choroidal thickness on treatment outcomes in PCV patients.
• To compare outcomes between anti-VEGF monotherapy and combination therapy (photodynamic therapy + anti-VEGF).

Main Methods:

• Prospective observational cohort study of 72 PCV patients.
• Evaluation of CVH using indocyanine green angiography.
• Measurement of central choroidal thickness via spectral domain optical coherence tomography.
• Assessment of visual acuity changes and anti-VEGF injection frequency over 12 months.

Main Results:

• CVH was present in 43.1% of eyes.
• Eyes with CVH showed significantly better visual acuity outcomes (P=0.033).
• In combination therapy, CVH (+) eyes required fewer injections (2.58/year) than CVH (-) eyes (4.68/year, P=0.0044).
• No significant correlation was found between choroidal thickening and treatment response.

Conclusions:

• CVH is associated with improved visual prognosis in PCV.
• CVH presence correlates with a reduced need for injections in combination therapy.
• CVH may serve as a valuable biomarker for guiding treatment decisions in PCV, particularly for combination therapy selection.