A novel classification of the vascular patterns of polypoidal choroidal vasculopathy and its relation to clinical outcomes

作者:Tan Colin S H*; Ngo Wei Kiong; Lim Louis W; Lim Tock Han
来源:British Journal of Ophthalmology, 2014, 98(11): 1528-1533.
DOI:10.1136/bjophthalmol-2014-305059

摘要

Purpose To propose a novel classification system for polypoidal choroidal vasculopathy (PCV), and compare the clinical outcomes among PCV subtypes. Methods Consecutive treatment-naive patients with symptomatic PCV were managed over 5 years. PCV subtypes were classified based on indocyanine green angiography (ICGA) and fluorescein angiography (FA) characteristics. Results Among 107 patients, 3 PCV subtypes were seen: Type A (interconnecting channels on ICGA) -22.4%; Type B (branching vascular network with no leakage) -24.3%; Type C (branching vascular network with late leakage on FA) -53.3%. The proportion of patients with best-corrected visual acuity (BCVA) >= 20/40 was highest in Type A, intermediate in Type B and lowest in Type C at all time points (80% vs 66.7% vs 7.7% at 5 years, p<0.001). The highest rate of moderate visual loss (loss of >= 3 lines) occurred in Type C PCV (57.7% vs 0% for Types B and A at 5 years, p<0.001). Risk factors for poor visual outcomes were PCV subtype (OR 53.7, p<0.001 for Type C and OR 13.7, p=0.023 for Type B compared to Type A) and age (OR 1.06, 95% CI 1.002 to 1.125, p=0.044). Conclusions The PCV subtype seen on initial presentation affects the long-term visual outcomes over a 5-year period.

  • 出版日期2014-11