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A novel classification of the vascular patterns of polypoidal choroidal vasculopathy and its relation to clinical outcomes
  1. Colin SH Tan1,2,
  2. Wei Kiong Ngo1,
  3. Louis W Lim1,
  4. Tock Han Lim1,2
  1. 1National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
  2. 2Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore
  1. Correspondence to Dr Colin SH Tan, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; Colintan_eye{at}yahoo.com.sg

Abstract

Purpose To propose a novel classification system for polypoidal choroidal vasculopathy (PCV), and compare the clinical outcomes among PCV subtypes.

Methods Consecutive treatment-naive patients with symptomatic PCV were managed over 5 years. PCV subtypes were classified based on indocyanine green angiography (ICGA) and fluorescein angiography (FA) characteristics.

Results Among 107 patients, 3 PCV subtypes were seen: Type A (interconnecting channels on ICGA) –22.4%; Type B (branching vascular network with no leakage) –24.3%; Type C (branching vascular network with late leakage on FA) –53.3%. The proportion of patients with best-corrected visual acuity (BCVA) ≥20/40 was highest in Type A, intermediate in Type B and lowest in Type C at all time points (80% vs 66.7% vs 7.7% at 5 years, p<0.001). The highest rate of moderate visual loss (loss of ≥3 lines) occurred in Type C PCV (57.7% vs 0% for Types B and A at 5 years, p<0.001). Risk factors for poor visual outcomes were PCV subtype (OR 53.7, p<0.001 for Type C and OR 13.7, p=0.023 for Type B compared to Type A) and age (OR 1.06, 95% CI 1.002 to 1.125, p=0.044).

Conclusions The PCV subtype seen on initial presentation affects the long-term visual outcomes over a 5-year period.

  • Retina
  • Macula
  • Imaging

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