Farvardin Mohsen, Amini Abdulrahim, Azizpourfard Younes, Yasemi Masoud, Mahdizad Zahra, Johari Mohammadkarim
Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran.
Department of ophthalmology, school of medicine, Hormozgan University of medical sciences, Bandar Abbas, Iran.
Int J Retina Vitreous. 2022 Oct 23;8(1):78. doi: 10.1186/s40942-022-00429-6.
to determine the percentage of patients with pachychoroid neovasculopathy (PNV) among patients who have been misdiagnosed and treated with wet age-related macular degeneration (AMD).
In this retrospective cross-sectional study, patients over 55 years old, who were diagnosed with wet AMD, were re-evaluated. All patients were recalled for examination and imaging. Patients with PNV were differentiated form wet AMD based on inclusion and exclusion criteria.
Overall, 120 patients (137 eyes) were recorded with wet AMD in the clinic. Finally, after complete re-evaluation, 94 (106 eyes) and 26 patients (31 eyes) were assigned to the AMD and the PNV group, respectively. Thus, a total of 20% of patients with primary mistake diagnosis of wet AMD, actually had PNV. The mean sub field choroidal thickness (SFCT) in the AMD and PNV groups was 173.8 ± 69 μm and 342 ± 27 μm, respectively. Drusen and pachydrusen were found in 69.9% and 24% of the cases with AMD and PNV, respectively (P = 0.001). The average number of intravitreal injections of anti-VEGF (vascular endothelial growth factor) required in the AMD and PNV groups was about 5 and 3, respectively, which was statistically significant (P-value 0.02).
This study revealed that about a one-fifth of wet AMD patients are actually pachychoroid neovasculopathy. These patients were younger and had thicker SFCT, and developed less subretinal scarring. Thus, the disorder must be considered as an important differential diagnosis of AMD-CNV.
确定在被误诊为湿性年龄相关性黄斑变性（AMD）并接受治疗的患者中，厚脉络膜新生血管病变（PNV）患者的比例。
在这项回顾性横断面研究中，对年龄超过55岁、被诊断为湿性AMD的患者进行重新评估。所有患者均被召回进行检查和成像。根据纳入和排除标准，将PNV患者与湿性AMD患者区分开来。
总体而言，诊所记录了120例（137只眼）湿性AMD患者。最终，经过全面重新评估后，分别有94例（106只眼）和26例（31只眼）患者被归入AMD组和PNV组。因此，最初被误诊为湿性AMD的患者中，实际上有20%患有PNV。AMD组和PNV组的平均亚视野脉络膜厚度（SFCT）分别为173.8±69μm和342±27μm。AMD和PNV病例中分别有69.9%和24%发现了玻璃膜疣和厚玻璃膜疣（P = 0.001）。AMD组和PNV组所需的抗血管内皮生长因子（VEGF）玻璃体腔内注射平均次数分别约为5次和3次，具有统计学意义（P值0.02）。
本研究表明，约五分之一的湿性AMD患者实际上是厚脉络膜新生血管病变。这些患者更年轻，SFCT更厚，视网膜下瘢痕形成较少。因此，该疾病必须被视为AMD-CNV的重要鉴别诊断。
