Polypoidal Choroidal Vasculopathy Based on Non-ICGA Criteria in White Patients With Neovascular Age-Related Macular Degeneration

Voraporn Chaikitmongkol, Malgorzata Ozimek, Titipol Srisomboon, Direk Patikulsila, Samantha Fraser-Bell, Jay Chhablani, Janejit Choovuthayakorn, Nawat Watanachai, Paradee Kunavisarut, Patricio J. Rodríguez-Valdés, David Lozano-Rechy, Marco Lupidi, Mayss Al-Sheikh, Adrian T. Fung, Catharina Busch, Hemal Mehta, Pierre Henry Gabrielle, Dinah Zur, Dan Ramon, Apisara SangkaewThammasin Ingviya, Atchara Amphornprut, Zafer Cebeci, Aude Couturier, Thais Sousa Mendes, Ermete Giancipoli, Matias Iglicki, Alessandro Invernizzi, Ines Lains, Matus Rehak, Anna Sala-Puigdollers, Mali Okada, Anat Loewenstein, Neil M. Bressler

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To determine prevalence of probable polypoidal choroidal vasculopathy (PCV) among White patients with neovascular age-related macular degeneration (nAMD) using non−indocyanine green angiography (ICGA) criteria DESIGN: Multicenter, multinational, retrospective, cross-sectional study. METHODS: A total of 208 treatment-naive eyes from Hispanic and non-Hispanic White individuals diagnosed with nAMD were included. All underwent color fundus photography (CFP), optical coherence tomography (OCT), and fluorescein angiography (FFA). De-identified images of study eyes were sent to 2 groups of graders. Group 1 reviewed CFP, OCT, and FFA to confirm nAMD diagnosis. Group 2 reviewed CFP and OCT to determine highly suggestive features for PCV. Probable PCV diagnosis defined as the presence of ≥2 of 4 highly suggestive features for PCV: notched or fibrovascular pigment epithelial detachment (PED) on CFP, sharply-peaked PED, notched PED, and hyperreflective ring on OCT. RESULTS: Eleven eyes were excluded because of poor image quality (6) or non-nAMD diagnosis (5). Of 197 eligible eyes (197 patients), the mean age (SD) was 78.8 years (8.9), 44.2% were men, 26.4% were Hispanic, and 73.6% were non-Hispanic White individuals; 41.1%, 23.4%, 9.1%, and 2.5% had ≥1, ≥2, ≥3, and 4 highly suggestive features. Results showed that 23.4% (95% CI, 17.6%-29.9%) had probable PCV diagnosis. Predominantly occult CNV was more frequently found in probable PCV than nAMD subgroup (84.8% vs 64.9%, P = .01). Hispanic White individuals had a lower prevalence of probable PCV than non-Hispanic White individuals (9.6% vs 28.2%, P = .006) CONCLUSIONS: These findings suggest that probable PCV occurs between 17.6% and 29.9% in White individuals with nAMD, and more commonly in non-Hispanic than in Hispanic White individuals.

Original languageEnglish
Pages (from-to)58-67
Number of pages10
JournalAmerican Journal of Ophthalmology
Volume244
DOIs
StatePublished - Dec 2022

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