National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore.
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Br J Ophthalmol. 2014 Nov;98(11):1528-33. doi: 10.1136/bjophthalmol-2014-305059. Epub 2014 Jul 4.
To propose a novel classification system for polypoidal choroidal vasculopathy (PCV), and compare the clinical outcomes among PCV subtypes.
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.
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).
The PCV subtype seen on initial presentation affects the long-term visual outcomes over a 5-year period.
提出一种新的息肉样脉络膜血管病变（PCV）分类系统，并比较不同 PCV 亚型的临床结局。
对 5 年内连续接受治疗的有症状 PCV 患者进行管理。根据吲哚菁绿血管造影（ICGA）和荧光素血管造影（FA）的特征对 PCV 亚型进行分类。
在 107 例患者中，观察到 3 种 PCV 亚型：A型（ICGA 上的连通通道）-22.4%；B 型（无渗漏的分支血管网络）-24.3%；C 型（FA 上有晚期渗漏的分支血管网络）-53.3%。在所有时间点，最佳矫正视力（BCVA）≥20/40 的患者比例A型最高，B 型次之，C 型最低（5 年时分别为 80%、66.7%和 7.7%，p<0.001）。C 型 PCV 中度视力丧失（损失≥3 行）发生率最高（5 年时分别为 57.7%、0%和 A 型，p<0.001）。视力不良结局的危险因素是 PCV 亚型（与 A 型相比，C 型 OR 53.7，p<0.001；B 型 OR 13.7，p=0.023）和年龄（OR 1.06，95%CI 1.002 至 1.125，p=0.044）。
初次就诊时所见的 PCV 亚型会影响 5 年内的长期视力结局。
