Characteristics of fine vascular network pattern associated with recurrence of polypoidal choroidal vasculopathy

Abstract

Objective To characterize an irregular capillary-like structure in the vascular network of eyes with polypoidal choroidal vasculopathy (PCV), and to determine whether its presence after photodynamic therapy (PDT) can be used to predict the clinical course of PCV. Methods We reviewed the clinical records of 29 eyes of 29 patients with PCV, who underwent PDT and confocal retinal angiographic examinations every 3 months. The images obtained before the PDT were compared with those after the PDT. The correlations between angiography findings and recurrences were evaluated. Results An area of fine, densely packed capillary-like vessels, named the fine vascular network, was identified within the polypoidal vascular network in 25 of 29 cases at the initial examination. The fine vascular network regressed in 23 cases (92%) after the first PDT. Thereafter, the fine vascular network remained or enlarged in 19 eyes, and 17 (84.5%) of these eyes had a recurrence of the polypoidal lesions or had exudative changes. In contrast, recurrences were found in only 2 of 10 (20%) eyes, whose fine network had regressed without a subsequent enlargement (Po0.001 compared with the former group). Conclusions A fine irregular vascular network is present in the majority of eyes with PCV before PDT. Its presence or expansion after PDT was significantly associated with a recurrence of PCV. Thus, we recommend that this network be monitored after treatment to determine whether a polypoidal vascular network will recur.

Identification and clinical role of choroidal neovascularization characteristics based on optical coherence tomography angiography

“…A previous study investigating ICG of polypoidal choroidal vasculopahy (PCV) patients reported that fine and dense capillary vessels (compatible with our defined DN) are associated with recurrence after PDT (Oishi et al 2011). A previous study investigating ICG of polypoidal choroidal vasculopahy (PCV) patients reported that fine and dense capillary vessels (compatible with our defined DN) are associated with recurrence after PDT (Oishi et al 2011).…”

“…Further studies implementing vascular growth behaviour may deliver more detailed insight into CNV progression and treatment response. A previous study investigating ICG of polypoidal choroidal vasculopahy (PCV) patients reported that fine and dense capillary vessels (compatible with our defined DN) are associated with recurrence after PDT (Oishi et al 2011). Spaide et al (2015;Spaide 2015) presented a descriptive study of treated CNV eyes secondary to AMD based on OCTA receiving periodic anti-VEGF injections.…”

Development of polypoidal choroidal vasculopathy in unaffected fellow eyes

“…In addition, BVN was noted outstandingly in the early phase of ICGA; meanwhile, LGH was determined in the late phase (figure 2). Recently, the angiographic feature of a fine irregular vascular network pattern was described, which was clinically similar to LGH; this pattern was correlated with recurrence 9 12. The authors thus suspected that LGH was an angiographic feature of leakage from the vascular network.…”

Polypoidal Choroidal Vasculopathy: Clinical Features and Genetic Predisposition

“…Moreover, it could be below the baseline value 5 years after the treatment [123,124,125]. Persistent BVN may be the origin of new polypoidal lesions [126]. In a recent prospective cohort study, 56 out of 139 eyes (40%) in the tAMD cases and 52 out of 107 eyes (49%) in the PCV cases were recurrent during the 60 months of follow-up after the initial PDT [123].…”