Age-related macular degeneration: is polypoidal choroidal vasculopathy recognized and treated?

Can J Ophthalmol. 2017 Oct;52(5):475-479. doi: 10.1016/j.jcjo.2017.02.014. Epub 2017 May 8.

Abstract

Objective: To assess how polypoidal choroidal vasculopathy (PCV) is recognized and treated, and to assess whether treatment outcomes are different between Chinese and Caucasian Canadian patients with age-related macular degeneration (AMD).

Design: Retrospective chart review.

Participants: 154 eyes from 135 Chinese patients and 2291 eyes from 1792 Caucasian patients who were newly diagnosed with either AMD or PCV and had more than 1 year of follow-up were included.

Methods: All newly diagnosed AMD patients presenting to the Retina Service of 3 Toronto University Hospitals, between March 25, 2008, to September 30, 2014, were reviewed.

Results: 10/154 eyes (6.5%) in Chinese Canadians and 16/2291 eyes (0.7%) in Caucasian Canadians were diagnosed as having PCV. Indocyanine green angiography (ICGA) was used to diagnose PCV in 20% of Chinese Canadians and 8.8% of Caucasian Canadians. Clinical practices with a larger percentage of Chinese patients were more likely to diagnose PCV in both Chinese (p = 0.004) and Caucasian patients (p = 0.03), were more likely to use photodynamic therapy (PDT) (p < 0.01), and had significantly greater central retinal thickness decrease (p < 0.001).

Conclusion: Our study has shown that PCV is under-recognized in a Canadian population, and ICGA is underutilized. In clinical practices with a greater portion of Chinese patients, PCV is more often recognized and PDT is used more liberally.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Asian People / ethnology
  • Canada / epidemiology
  • China / epidemiology
  • Choroidal Neovascularization / diagnosis*
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / surgery
  • Choroidal Neovascularization / therapy
  • Coloring Agents / administration & dosage*
  • Combined Modality Therapy
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green / administration & dosage*
  • Macular Degeneration / diagnosis*
  • Macular Degeneration / drug therapy
  • Macular Degeneration / surgery
  • Macular Degeneration / therapy
  • Male
  • Photochemotherapy*
  • Polyps / diagnosis*
  • Polyps / drug therapy
  • Polyps / surgery
  • Polyps / therapy
  • Retrospective Studies
  • Visual Acuity / physiology
  • White People / ethnology

Substances

  • Angiogenesis Inhibitors
  • Coloring Agents
  • Indocyanine Green