Assessing Polypoidal Choroidal Vasculopathy-Related OCT Features in the TENAYA and LUCERNE Trials

To describe OCT features associated with polypoidal choroidal vasculopathy (PCV) in the TENAYA and LUCERNE clinical trial cohorts.

Imaging analysis within 2 multinational, double-masked, randomized controlled phase III trials.

Participants with treatment-naïve neovascular age-related macular degeneration enrolled in TENAYA and LUCERNE with baseline OCT and in a subset, baseline indocyanine green angiography (ICGA).

Previously described OCT features associated with PCV were evaluated among 1329 participants. Two major OCT features were evaluated (sharp-peaked pigment epithelial detachment [SPED] and sub-retinal pigment epithelium ring-like lesion) to determine the occurrence of OCT-defined PCV. Subretinal fluid, intraretinal fluid (IRF), and hyperreflective material (HRM), were compared between OCT-defined PCV and non-PCV eyes. A sensitivity analysis was performed in the subset of eyes with available ICGA to assess concordance between OCT and ICGA-confirmed PCV.

Occurrence of OCT-defined PCV and distribution of OCT-based disease activity biomarkers by PCV status.

Using the 2 major OCT criteria, 88 (6.7%) of eyes were classified as OCT-defined PCV. Fewer OCT-defined PCV eyes had IRF and HRM compared with non-PCV eyes (27.3% vs. 45.5%, P = 0.002, 19.3% vs. 47.0%, P < 0.001). In the ICGA subset (n = 274), the combination of SPED and ring demonstrated good sensitivity (85.2%) and high specificity (98.8%) relative to ICGA.

Using 2 Asia-Pacific Ocular Imaging Society major OCT features, OCT-based diagnostic strategy may help triage or screen for PCV when ICGA is unavailable.

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.