Department of Ophthalmology, Sapporo City General Hospital, 1-1 Kita 11-jo Nishi 13-Chome, Chuo-ku, Sapporo, 060-8604, Japan.
Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1741-1750. doi: 10.1007/s00417-020-05033-8. Epub 2021 Jan 6.
Visual function and treatment response after anti-vascular endothelial growth factor monotherapy were compared between polypoidal choroidal vasculopathy (PCV) with and without hemorrhage.
We conducted a retrospective, observational study (mean, 26 months) for 49 eyes of 49 treatment-naive patients with PCV. Patients were classified into PCV with hemorrhage (26 eyes) or without hemorrhage (23 eyes). PCV with massive hemorrhage subgroup has four or more disc-hemorrhagic areas and included five eyes.
There were no significant differences in patient age, sex, systolic blood pressure, diastolic blood pressure, presence of choroidal vascular hyperpermeability, number of polyps, maximum polyp size, lesion area, and presence of pigment epithelium detachment (PED) between the two groups. Except for the course of PCV-related hemorrhage, treatment number and its response were similar between the groups. Best-corrected visual acuity at the last visit in PCV with hemorrhage was 0.33 ± 0.51 logMAR (20/41) comparable with 0.28 ± 0.41 logMAR (20/38) without hemorrhage at the last visit (p = 0.944). Maximum polyp size in massive hemorrhagic PCV was significantly larger (314.6 ± 111.4 μm) than that of small hemorrhagic PCV (229.0 ± 119.1 μm; p = 0.037). All PCV with massive hemorrhage was accompanied by large hemorrhagic PED.
There were no significant differences in the baseline characteristics, treatment intervention, or suppression of disease activity between PCV with and without hemorrhage. Final visual acuity of PCV did not differ with or without hemorrhage. Development of massive hemorrhaging in PCV may be associated with both large polyps and hemorrhagic PED.
比较有出血和无出血的息肉样脉络膜血管病变（PCV）患者接受抗血管内皮生长因子单药治疗后的视力功能和治疗反应。
我们对 49 例未经治疗的 PCV 患者的 49 只眼进行了回顾性、观察性研究（平均 26 个月）。患者分为有出血的 PCV（26 只眼）和无出血的 PCV（23 只眼）。PCV 伴大量出血亚组有 4 个或更多盘状出血区，包括 5 只眼。
两组患者的年龄、性别、收缩压、舒张压、脉络膜血管通透性、息肉数量、最大息肉大小、病变面积和色素上皮脱离（PED）的存在均无显著差异。除 PCV 相关出血病程外，两组患者的治疗次数及其反应相似。有出血的 PCV 末次随访时最佳矫正视力为 0.33±0.51 logMAR（20/41），无出血的 PCV 末次随访时为 0.28±0.41 logMAR（20/38），两组比较差异无统计学意义（p=0.944）。大量出血性 PCV 的最大息肉大小（314.6±111.4 μm）明显大于小出血性 PCV（229.0±119.1 μm；p=0.037）。所有伴大量出血的 PCV 均伴有大的出血性 PED。
有出血和无出血的 PCV 患者在基线特征、治疗干预或疾病活动抑制方面无显著差异。PCV 的最终视力不因出血而有所不同。PCV 发生大量出血可能与大息肉和出血性 PED 均有关。
