Author: Colin Tan (Singapore)
Co-authors: Wei Kiong Ngo, Louis Lim
Purpose
While polypoidal choroidal vasculopathy (PCV) and typical neovascular age-related macular degeneration (nAMD) share common clinical features, they have considerably different clinical course and visual prognosis. Since PCV and nAMD appear similar on fluorescein angiography (FA), distinguishing between them based on FA findings alone is a challenge. However, specific FA findings may indicate the presence of PCV when indocyanine green angiography (ICGA) is contraindicated or unavailable. Here, we describe some FA features that may differentiate PCV from nAMD cases and have determined their predictive values.
Setting/Venue
Multicenter, randomized, controlled clinical study.
Methods
FA and ICGA images of 76 patients (61 PCV and 15 nAMD) screened for the prospective, multicenter, randomized, controlled EVEREST study were independently graded using standardized diagnostic criteria. Multiple logistic regression analysis was used to obtain the predictive values of FA features for PCV.
Results
An occult pattern of leakage on FA was predominant in patients with PCV as compared with those with nAMD (95.0% vs 73.3%). The other features on FA that were associated with the presence of PCV included the presence of a leaking nodular hyperfluorescent area on FA (80.0% vs 20.00%, p<0.001, sensitivity 80%, positive predictive value [PPV] 94.1%) and blockage of fluorescence (61.7% vs 13.3%, p=0.001, sensitivity 95%, PPV 83.8%).
Conlusions
Several distinguishing features identified on FA were highly predictive of PCV compared to nAMD cases. In the absence or contraindication of ICGA, FA characteristics may help identify patients who are likely to have PCV. The presence of such features on FA should be considered as highly indicative of PCV.
Financial Disclosure
Novartis - conference support Bayer - conference support
Comments
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