Recognition and treatment of polypoidal choroidal vasculopathy and age-related macular degeneration in British Columbia

OBJECTIVE: To assess ethnic differences in the prevalence, diagnosis, and management of polypoidal choroidal vasculopathy (PCV) compared to typical neovascular age-related macular degeneration (nAMD) among Chinese and Caucasian patients in British Columbia. METHODS: A retrospective chart review was conducted between 2008 and 2013 based on predefined inclusion criteria. Demographic, diagnostic, and clinical outcome data—including race, lesion type, diagnostic modality, and treatment response—were extracted and analyzed using RStudio. RESULTS: Of the 416 eyes reviewed, 92.07% (383/416, N = Total sample number) were from Caucasian patients and 7.93% (33/416, N = Total sample number) from Chinese patients. No statistically significant difference in median age at diagnosis was observed between ethnic groups. ICGA was used in 3.57% (2/56, N = Total number of PCV cases) of PCV cases. Anti-VEGF monotherapy was the predominant treatment modality, while combination therapy with photodynamic therapy (PDT) was employed in 5.38% (22/353 + 56) of cases. There were no significant differences in visual acuity (VA) gains or central retinal thickness (CRT) reductions between PCV and nAMD diagnoses, nor between ethnic groups. Under anti-VEGF monotherapy, visual acuity and central retinal thickness outcomes were similar between PCV and nAMD and across the ethnic groups evaluated, within the limitations of the study design. CONCLUSION: PCV, though less common than typical nAMD, was identified in both Chinese and Caucasian patients, with a trend toward younger age at presentation compared to nAMD. The low utilization of ICGA may contribute to the underdiagnosis of PCV. Nevertheless, anti-VEGF monotherapy yielded comparable outcomes across diagnoses and ethnicities, underscoring the importance of equitable diagnostic and therapeutic strategies in nAMD care.