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 Sangkaew; Thammasin 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

doi:10.1016/j.ajo.2022.07.024

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

Am J Ophthalmol. 2022 Dec:244:58-67. doi: 10.1016/j.ajo.2022.07.024. Epub 2022 Aug 8.

Authors

Voraporn Chaikitmongkol¹, Malgorzata Ozimek², Titipol Srisomboon³, Direk Patikulsila¹, Samantha Fraser-Bell⁴, Jay Chhablani⁵, Janejit Choovuthayakorn¹, Nawat Watanachai¹, Paradee Kunavisarut¹, Patricio J Rodríguez-Valdés⁶, David Lozano-Rechy⁷, Marco Lupidi⁸, Mayss Al-Sheikh⁹, Adrian T Fung¹⁰, Catharina Busch¹¹, Hemal Mehta¹², Pierre-Henry Gabrielle¹³, Dinah Zur¹⁴, Dan Ramon¹⁴, Apisara Sangkaew¹, Thammasin Ingviya¹⁵, Atchara Amphornprut¹⁶, Zafer Cebeci¹⁷, Aude Couturier¹⁸, Thais Sousa Mendes¹⁹, Ermete Giancipoli²⁰, Matias Iglicki²¹, Alessandro Invernizzi²², Ines Lains²³, Matus Rehak²⁴, Anna Sala-Puigdollers²⁵, Mali Okada²⁶, Anat Loewenstein¹⁴, Neil M Bressler²⁷

Affiliations

¹ 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.
² Department of General Ophthalmology (M.O.), Medical University in Lublin, Lublin, Poland; Eye Surgery Center Prof. Zagorski (M.O.), Nowy Sacz, Poland.
³ 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.
⁴ Department of Ophthalmology (S.F.-B.), Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
⁵ 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.
⁶ Instituto de Oftalmologia y Ciencias Visuales (P.J.R.-V.), Hospital Zambrano Hellion, Tecnologico de Monterrey, Monterrey, Mexico.
⁷ Conde de Valenciana Eye Institute (D.L.-R.), Ciudad de México, México.
⁸ 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.
⁹ Department of Ophthalmology (M.A.-S.), University Hospital Zurich, University of Zurich, Zurich, Switzerland.
¹⁰ 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.
¹¹ Department of Ophthalmology (C.B., M.R.), University of Leipzig, Leipzig, Germany.
¹² Department of Ophthalmology (H.M.), Royal Free London NHS Foundation Trust, London, UK.
¹³ Department of Ophthalmology (P.-H.G.), University Hospital Dijon, Dijon, France.
¹⁴ Division of Ophthalmology (D.Z., D.R., A.L.), Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹⁵ Department of Family Medicine and Preventive Medicine (T.I.), Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
¹⁶ Retina Division, Department of Ophthalmology (A.A.), Faculty of Medicine, Rajvithi Hospital, Rangsit University, Bangkok, Thailand.
¹⁷ Department of Ophthalmology (Z.C.), Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
¹⁸ Ophthalmology Department A.C.), Université de Paris, AP-HP, Hôpital Lariboisière, Paris, France.
¹⁹ Department of Ophthalmology (T.S.M.), Federal University of Sao Paulo, Sao Paulo, Brazil.
²⁰ Department of Ophthalmology (E.G.), "Ospedale Vito Fazzi", Piazza Filippo Muratore, Lecce, Italy.
²¹ University of Buenos Aires (M.I .), Buenos Aires, Argentina.
²² 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.
²³ Department of Ophthalmology (I.L.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
²⁴ Department of Ophthalmology (C.B., M.R.), University of Leipzig, Leipzig, Germany; Department of Ophthalmology (M.R.), Justus-Liebig University Giessen, Giessen, Germany.
²⁵ 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.
²⁶ Department of Ophthalmology (M.O.), Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
²⁷ Retina Division (N.M.B.), Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. Electronic address: [email protected].

PMID: 35952753
DOI: 10.1016/j.ajo.2022.07.024

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.

Publication types

Multicenter Study

MeSH terms

Aged
Choroid / blood supply
Choroidal Neovascularization* / diagnosis
Choroidal Neovascularization* / epidemiology
Cross-Sectional Studies
Female
Fluorescein Angiography / methods
Humans
Macular Degeneration*
Male
Polyps* / diagnosis
Polyps* / epidemiology
Retinal Detachment*
Retrospective Studies
Tomography, Optical Coherence / methods
White People