Polypoidal Choroidal Vasculopathy Based on Non-ICGA Criteria in White Patients With Neovascular Age-Related Macular Degeneration - 25/11/22

Doi : 10.1016/j.ajo.2022.07.024

Voraporn Chaikitmongkol ^a, Malgorzata Ozimek ^b,^c, Titipol Srisomboon ^a,^d, Direk Patikulsila ^a, Samantha Fraser-Bell ^e, Jay Chhablani ^a,^f, Janejit Choovuthayakorn ^a, Nawat Watanachai ^a, Paradee Kunavisarut ^a, Patricio J. Rodríguez-Valdés ^g, David Lozano-Rechy ^h, Marco Lupidi ^i,^j, Mayss Al-Sheikh ^k, Adrian T. Fung ^l,^m, Catharina Busch ⁿ, Hemal Mehta ^o, Pierre-Henry Gabrielle ^p, Dinah Zur ^q, Dan Ramon ^q, Apisara Sangkaew ^a, Thammasin Ingviya ^r, Atchara Amphornprut ^s, Zafer Cebeci ^t, Aude Couturier ^u, Thais Sousa Mendes ^v, Ermete Giancipoli ^w, Matias Iglicki ^x, Alessandro Invernizzi ^y,^z, Ines Lains ^aa, Matus Rehak ^n,^bb, Anna Sala-Puigdollers ^a,^cc, Mali Okada ^dd, Anat Loewenstein ^q, Neil M. Bressler ^ee,^⁎
^a Retina Division (V.C., T.S., D.P., J.C., N.W., P.K., A.S.), Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
^b Department of General Ophthalmology (M.O.), Medical University in Lublin, Lublin, Poland
^c Eye Surgery Center Prof. Zagorski (M.O.), Nowy Sacz, Poland
^d Department of Ophthalmology (T.S.), Nakornping Hospital, Chiang Mai, Thailand
^e Department of Ophthalmology (S.F.-B.), Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
^f Department of Ophthalmology (J.C.), University of Pittsburgh Eye Center, Pittsburgh, Pennsylvania, USA
^g Instituto de Oftalmologia y Ciencias Visuales (P.J.R.-V.), Hospital Zambrano Hellion, Tecnologico de Monterrey, Monterrey, Mexico
^h Conde de Valenciana Eye Institute (D.L.-R.), Ciudad de México, México
ⁱ Eye Clinic (L.R.), Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
^j Fondazione per la Macula Onlus, Di.N.O.G.Mi., Section of Ophthalmology, University of Perugia, Perugia, Italy
^k Department of Ophthalmology (M.A.-S.), University Hospital Zurich, University of Zurich, Zurich, Switzerland
^l Westmead and Central Clinical Schools (A.T.F.), Specialty of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia
^m Department of Ophthalmology(A.T.F.), Faculty of Medicine, Health and Human Sciences, Macquarie University Hospital, Sydney, New South Wales, Australia
ⁿ Department of Ophthalmology (C.B., M.R.), University of Leipzig, Leipzig, Germany
^o Department of Ophthalmology (H.M.), Royal Free London NHS Foundation Trust, London, UK
^p Department of Ophthalmology (P.-H.G.), University Hospital Dijon, Dijon, France
^q Division of Ophthalmology (D.Z., D.R., A.L.), Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
^r Department of Family Medicine and Preventive Medicine (T.I.), Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
^s Retina Division, Department of Ophthalmology (A.A.), Faculty of Medicine, Rajvithi Hospital, Rangsit University, Bangkok, Thailand
^t Department of Ophthalmology (Z.C.), Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
^u Ophthalmology Department A.C.), Université de Paris, AP-HP, Hôpital Lariboisière, Paris, France
^v Department of Ophthalmology (T.S.M.), Federal University of Sao Paulo, Sao Paulo, Brazil
^w Department of Ophthalmology (E.G.), “Ospedale Vito Fazzi”, Piazza Filippo Muratore, Lecce, Italy
^x University of Buenos Aires (M.I .), Buenos Aires, Argentina
^y Eye Clinic - Department of Biomedical and Clinical Science “Luigi Sacco” (A.I.)'', Luigi Sacco Hospital, University of Milan, Milan, Italy
^z Save Sight Institute, Discipline of Ophthalmology (A.I.), Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
^aa Department of Ophthalmology (I.L.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
^bb Department of Ophthalmology (M.R.), Justus-Liebig University Giessen, Giessen, Germany
^cc Institut Clínic d'Oftalmologia (ICOF) (A.S.-P.), Hospital Clínic de Barcelona, Barcelona, Spain
^dd Department of Ophthalmology (M.O.), Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
^ee Retina Division (N.M.B.), Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

^⁎Inquiries to Neil M. Bressler, Johns Hopkins Hospital, Baltimore, Maryland, USA.Johns Hopkins HospitalBaltimoreMarylandUSA

Résumé

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.

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Plan

METHODS

RESULTS

PRESENCE OF HIGHLY SUGGESTIVE FEATURES

PROBABLE PCV DIAGNOSIS

DISCUSSION

Supplemental Material available at AJO.com.

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Vol 244

P. 58-67 - décembre 2022 Retour au numéro

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Polypoidal Choroidal Vasculopathy Based on Non-ICGA Criteria in White Patients With Neovascular Age-Related Macular Degeneration - 25/11/22

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