PREVALENCE AND CLINICAL CHARACTERISTICS OF PACHYDRUSEN IN POLYPOIDAL CHOROIDAL VASCULOPATHY: Multimodal Image Study

To investigate the prevalence of a newly defined drusen type, pachydrusen, soft drusen, and subretinal drusenoid deposits in eyes with polypoidal choroidal vasculopathy and fellow eyes and the relationship between each drusen type and the choroidal thickness, vascular morphology, and hyperpermeability.

The 169 eyes of 90 patients with polypoidal choroidal vasculopathy were retrospectively reviewed. The prevalence of each drusen type was evaluated using color fundus photography and optical coherence tomography. The choroidal thickness and presence of pachyvessels on optical coherence tomography and choroidal vascular hyperpermeability on indocyanine green angiography were compared among the drusen groups.

Pachydrusen, soft drusen, and subretinal drusenoid deposits were found in 49.3%, 12.3%, and 6.9% in polypoidal choroidal vasculopathy eyes. The mean subfoveal choroidal thickness of the pachydrusen, soft drusen, and subretinal drusenoid deposit groups was 403.1, 184.4, and 176.4 µm. The pachydrusen group showed significantly thicker choroid than the others. The choroidal hyperpermeability was noticed at 41.7%, 0%, and 0% and the pachyvessel was observed at 80.6%, 44.4%, and 40% in pachydrusen, soft drusen, and subretinal drusenoid deposit groups, respectively.

In patients with polypoidal choroidal vasculopathy, pachydrusen was prevalent and associated with thicker choroid. Polypoidal choroidal vasculopathy with pachydrusen was highly associated with choroidal vascular hyperpremeability and pachyvessel morphology than other types of drusen.