Towards a specific classification of polypoidal choroidal vasculopathy: idiopathic disease or subtype of age-related macular degeneration

Session Details

Session Title: AMD I

Session Date/Time: Thursday 17/09/2015 | 08:30-10:30

Paper Time: 09:10

Venue: Athena

First Author: : M.Lupidi FRANCE

Co Author(s): :    G. Coscas   F. Coscas   J. Zerbib   A. Dirani   O. Semoun   E. Souied

Abstract Details

PURPOSE:To suggest a clinical distinction between idiopathic Polypoidal Choroidal Vasculopathy (PCV) and secondary polyps associated with neo-vascular age related macular degeneration (NV-AMD).

Setting:

“Odeon Ophthalmology Center” and “Creteil University Hospital” (Paris, France)

Methods:

Retrospective case series of 52 eyes of 52 consecutive patients (31 females and 21 males) diagnosed with PCV. Initial diagnosis was based on SLO-Indocyanine green angiography (ICGA) in association with Fluorescein angiography (FA) and Optical coherence tomography (OCT). All the data and images were analyzed in a masked fashion by four experienced examiners, in two different sessions: the first one to classify patients into the two hypothesized groups (idiopathic polyps or NV-AMD related polyps); the second one, following a pre-determined scheme, to describe objective features. The results obtained in each session underwent a cross multivariate analysis to identify statistically significant differences (p < 0.05) between the two groups.

Results:

The two groups were clinically different, based on FA (leakage origin [p=0.001] and presence of drusen [p=0.001]), ICGA (evidence of choroidal neovascularization [CNV] [p=0.001] and/or branching vascular network [BVN] [p=0.001]), OCT imaging (type of pigmented epithelium detachment [p=0.001], presence of BVN [p=0.001], and choroidal thickness [p=0.001]). Further significant differences were observed according to the location of lesion (uni or multifocal) [p=0.001], type of CNV [p=0.001], and best-corrected visual acuity (BCVA) [p=0.001].

Conclusions:

Our study demonstrated clinical and statistically significant differences between idiopathic PCV and NV-AMD related polyps that could be considered as distinct entities. Although they share some similarities, mainly the sub-RPE location, the ability to identify a specific clinical pattern suggests a more specific therapeutic approach for these two entities.