Yadav Sohraab, Parry David G, Beare Nick A V, Pearce Ian A
St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
Br J Ophthalmol. 2017 Oct;101(10):1377-1380. doi: 10.1136/bjophthalmol-2016-310074. Epub 2017 Mar 7.
To describe the prevalence of polypoidal choroidal vasculopathy (PCV) in a Caucasian population with neovascular age-related macular degeneration (NAMD).
All patients referred to a city AMD service over a 2-year period underwent imaging including Indocyanine Green Angiography at baseline. A panel of experts confirmed the patients with NAMD and diagnosed the lesion type including PCV. The proportion of Caucasian patients with PCV was identified. Two authors independently reviewed clinical imaging and recorded data of patients with PCV on lesion characteristics. Further information including treatments received and visual acuity at different time points was analysed.
A total of 492 patients were diagnosed with NAMD during the 2-year study period. Of these patients, 204 had occult lesions (41.5%). PCV was identified in 45 patients (22.1% of occult NAMD and 9.1% of all NAMD). 23 patients received anti-vascular endothelial growth factor (VEGF) monotherapy, 8 received verteporfin photodynamic therapy (PDT) monotherapy and the remaining 14 patients were managed with combined PDT and anti-VEGF treatment.
The prevalence of PCV in Caucasians is higher than previously reported. Indocyanine Green Angiography should be a standard investigation for all new patients with NAMD, particularly those with occult NAMD, to avoid missing this important subset.
描述息肉状脉络膜血管病变(PCV)在患有新生血管性年龄相关性黄斑变性(NAMD)的白种人群中的患病率。
在两年期间转诊至某城市AMD服务机构的所有患者在基线时均接受了包括吲哚菁绿血管造影在内的影像学检查。一组专家对NAMD患者进行了确诊,并对病变类型(包括PCV)进行了诊断。确定了患有PCV的白种患者的比例。两位作者独立复查了临床影像学资料,并记录了PCV患者的病变特征数据。分析了包括所接受的治疗以及不同时间点的视力等进一步信息。
在为期两年的研究期间,共有492例患者被诊断为NAMD。在这些患者中,204例有隐匿性病变(41.5%)。45例患者被确诊为PCV(占隐匿性NAMD的22.1%,占所有NAMD的9.1%)。23例患者接受了抗血管内皮生长因子(VEGF)单药治疗,8例接受了维替泊芬光动力疗法(PDT)单药治疗,其余14例患者接受了PDT与抗VEGF联合治疗。
白种人中PCV的患病率高于先前报道。吲哚菁绿血管造影应作为所有新诊断的NAMD患者,尤其是隐匿性NAMD患者的标准检查,以避免遗漏这一重要亚组。