Pachyvitelliform Maculopathy: Clinical Features and Natural History

Area of Science:

• Ophthalmology
• Retinal Diseases
• Choroid Diseases

Background:

• Pachyvitelliform maculopathy (PVM) is a condition within the pachychoroid disease spectrum (PDS).
• Understanding PVM's characteristics is crucial for managing patients with PDS.

Purpose of the Study:

• To determine the prevalence and clinical features of PVM in patients with PDS.
• To identify factors associated with PVM development and progression.
• To analyze the natural history and visual prognosis of PVM.

Main Methods:

• Retrospective cohort study of patients with PDS.
• Diagnosis of PVM based on spectral-domain OCT and fundus autofluorescence imaging.
• Longitudinal tracking of acquired vitelliform lesions (AVLs) using serial OCT and multivariable regression analysis.

Main Results:

• PVM was found in 5% of 986 eyes with PDS.
• Key associations included recurrent fluid, thinner outer nuclear layer, and choroidal folds.
• Lesions showed slow turnover (median 50 months), with rare complications and stable visual acuity over 7 years.

Conclusions:

• PVM is a distinct phenotype of PDS with prolonged lesion persistence and recurrent fluid.
• PVM has a relatively benign visual prognosis.
• Choroidal changes and RPE dysfunction are implicated in PVM pathogenesis.