Effects of choroidal vascular hyperpermeability on anti-vascular endothelial growth factor treatment for polypoidal choroidal vasculopathy.

PURPOSE: To evaluate the effect of choroidal vascular hyperpermeability, as determined using indocyanine green angiography (ICGA), on the outcome of anti-vascular endothelial growth factor (VEGF) treatment for polypoidal choroidal vasculopathy (PCV).

DESIGN: Retrospective comparative series.

METHODS: Based on the presence of choroidal vascular hyperpermeability on ICGA, 103 eyes (101 patients) with PCV were categorized into 2 subgroups: choroidal vascular hyperpermeability (+) group (41 eyes) and choroidal vascular hyperpermeability (-) group (62 eyes). All subjects were treatment naïve and treated by anti-VEGF with initial 3 loading injections per month, followed by an as-needed reinjection. Best-corrected visual acuity (BCVA) and central macular thickness after treatment were compared between the 2 groups at baseline and at 3, 6, 9, and 12 months.

RESULTS: At 12 months after treatment, mean BCVA was significantly improved from 0.68 logarithm of the minimal angle of resolution (logMAR) (20/95 Snellen equivalent) to 0.50 logMAR (20/63 Snellen equivalent) in the choroidal vascular hyperpermeability (-) group (P = .01); however, there was no significant improvement, from 0.79 logMAR (20/123 Snellen equivalent) to 0.74 logMAR (20/109 Snellen equivalent), in the choroidal vascular hyperpermeability (+) group. In paired comparisons of BCVA between baseline and each follow-up visit, the choroidal vascular hyperpermeability (-) group showed significant improvement of BCVA at every follow-up visit (P < .05); however, the choroidal vascular hyperpermeability (+) group did not show significant visual improvement after 9 months (P > .05).

CONCLUSIONS: The therapeutic response to anti-VEGF treatment for PCV in patients with choroidal vascular hyperpermeability decreased over time. Choroidal vascular hyperpermeability was associated with an inferior visual outcome after intravitreal anti-VEGF treatment for PCV.