Polypoidal Choroidal Vasculopathy Based on Non-ICGA Criteria in White Patients With Neovascular Age-Related Macular Degeneration,American Journal of Ophthalmology

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Polypoidal Choroidal Vasculopathy Based on Non-ICGA Criteria in White Patients With Neovascular Age-Related Macular Degeneration
American Journal of Ophthalmology ( IF 4.1 ) Pub Date : 2022-08-08 , DOI: 10.1016/j.ajo.2022.07.024
Voraporn Chaikitmongkol ₁ , Malgorzata Ozimek ₂ , Titipol Srisomboon ₃ , Direk Patikulsila ₁ , Samantha Fraser-Bell ₄ , Jay Chhablani ₅ , Janejit Choovuthayakorn ₁ , Nawat Watanachai ₁ , Paradee Kunavisarut ₁ , Patricio J Rodríguez-Valdés ₆ , David Lozano-Rechy ₇ , Marco Lupidi ₈ , Mayss Al-Sheikh ₉ , Adrian T Fung ₁₀ , Catharina Busch ₁₁ , Hemal Mehta ₁₂ , Pierre-Henry Gabrielle ₁₃ , Dinah Zur ₁₄ , Dan Ramon ₁₄ , Apisara Sangkaew ₁ , Thammasin Ingviya ₁₅ , Atchara Amphornprut ₁₆ , Zafer Cebeci ₁₇ , Aude Couturier ₁₈ , Thais Sousa Mendes ₁₉ , Ermete Giancipoli ₂₀ , Matias Iglicki ₂₁ , Alessandro Invernizzi ₂₂ , Ines Lains ₂₃ , Matus Rehak ₂₄ , Anna Sala-Puigdollers ₂₅ , Mali Okada ₂₆ , Anat Loewenstein ₁₄ , Neil M Bressler ₂₇

Affiliation

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.
Department of General Ophthalmology (M.O.), Medical University in Lublin, Lublin, Poland; Eye Surgery Center Prof. Zagorski (M.O.), Nowy Sacz, Poland.
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; Department of Ophthalmology (T.S.), Nakornping Hospital, Chiang Mai, Thailand.
Department of Ophthalmology (S.F.-B.), Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
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; Department of Ophthalmology (J.C.), University of Pittsburgh Eye Center, Pittsburgh, Pennsylvania, USA.
Instituto de Oftalmologia y Ciencias Visuales (P.J.R.-V.), Hospital Zambrano Hellion, Tecnologico de Monterrey, Monterrey, Mexico.
Conde de Valenciana Eye Institute (D.L.-R.), Ciudad de México, México.
Eye Clinic (L.R.), Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy; Fondazione per la Macula Onlus, Di.N.O.G.Mi., Section of Ophthalmology, University of Perugia, Perugia, Italy.
Department of Ophthalmology (M.A.-S.), University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Westmead and Central Clinical Schools (A.T.F.), Specialty of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Ophthalmology(A.T.F.), Faculty of Medicine, Health and Human Sciences, Macquarie University Hospital, Sydney, New South Wales, Australia.
Department of Ophthalmology (C.B., M.R.), University of Leipzig, Leipzig, Germany.
Department of Ophthalmology (H.M.), Royal Free London NHS Foundation Trust, London, UK.
Department of Ophthalmology (P.-H.G.), University Hospital Dijon, Dijon, France.
Division of Ophthalmology (D.Z., D.R., A.L.), Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Family Medicine and Preventive Medicine (T.I.), Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Retina Division, Department of Ophthalmology (A.A.), Faculty of Medicine, Rajvithi Hospital, Rangsit University, Bangkok, Thailand.
Department of Ophthalmology (Z.C.), Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Ophthalmology Department A.C.), Université de Paris, AP-HP, Hôpital Lariboisière, Paris, France.
Department of Ophthalmology (T.S.M.), Federal University of Sao Paulo, Sao Paulo, Brazil.
Department of Ophthalmology (E.G.), "Ospedale Vito Fazzi", Piazza Filippo Muratore, Lecce, Italy.
University of Buenos Aires (M.I .), Buenos Aires, Argentina.
Eye Clinic - Department of Biomedical and Clinical Science "Luigi Sacco" (A.I.)'', Luigi Sacco Hospital, University of Milan, Milan, Italy; Save Sight Institute, Discipline of Ophthalmology (A.I.), Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Department of Ophthalmology (I.L.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Department of Ophthalmology (C.B., M.R.), University of Leipzig, Leipzig, Germany; Department of Ophthalmology (M.R.), Justus-Liebig University Giessen, Giessen, Germany.
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; Institut Clínic d'Oftalmologia (ICOF) (A.S.-P.), Hospital Clínic de Barcelona, Barcelona, Spain.
Department of Ophthalmology (M.O.), Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Retina Division (N.M.B.), Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

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.

中文翻译：

基于非 ICGA 标准的新生血管性年龄相关性黄斑变性白人患者的息肉状脉络膜血管病变

目的

使用非吲哚青绿血管造影 (ICGA) 标准确定新生血管性年龄相关性黄斑变性 (nAMD) 白人患者可能的息肉状脉络膜血管病变 (PCV) 的患病率

设计

多中心、跨国、回顾性、横断面研究。

方法

总共包括来自被诊断患有 nAMD 的西班牙裔和非西班牙裔白人的 208 只未经治疗的眼睛。所有患者均接受了彩色眼底照相 (CFP)、光学相干断层扫描 (OCT) 和荧光素血管造影 (FFA)。研究眼睛的去识别图像被发送给 2 组评分者。第 1 组审查了 CFP、OCT 和 FFA 以确认 nAMD 诊断。第 2 组审查了 CFP 和 OCT，以确定 PCV 的高度提示性特征。可能的 PCV 诊断定义为存在 4 项高度提示 PCV 的特征中的 2 项以上：CFP 上的切迹或纤维血管色素上皮脱离 (PED)、尖峰 PED、切迹 PED 和 OCT 上的高反射环。

结果

由于图像质量差 (6) 或非 nAMD 诊断 (5)，有 11 只眼睛被排除在外。在 197 只符合条件的眼睛（197 名患者）中，平均年龄 (SD) 为 78.8 岁 (8.9)，44.2% 为男性，26.4% 为西班牙裔，73.6% 为非西班牙裔白人；41.1%、23.4%、9.1% 和 2.5% 的患者具有≥1、≥2、≥3 和 4 个高度提示特征。结果显示，23.4%（95% CI，17.6%-29.9%）的患者可能诊断为 PCV。与 nAMD 亚组相比，在可能的 PCV 中更常发现隐匿性 CNV（84.8% 对 64.9%，P = .01）。西班牙裔白人的可能 PCV 患病率低于非西班牙裔白人 (9.6% vs 28.2%, P = .006)