Optical Coherence Tomography Features for Identifying Posttreatment Complete Polypoidal Regression in Polypoidal Choroidal Vasculopathy

Voraporn Chaikitmongkol, Thanaphat Chaovisitsaree, Direk Patikulsila, Paradee Kunavisarut, Nopasak Phasukkijwatana, Nawat Watanachai, Janejit Choovuthayakorn, Sirawit Isipradit, Pawinee Boonyot, Apisara Sangkaew, Thammasin Ingviya, Susan B. Bressler, Neil M. Bressler

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine accuracy and relative risk (RR) of posttreatment optical coherence tomography (OCT) features in identifying complete or incomplete polypoidal regression in polypoidal choroidal vasculopathy (PCV). Design: Validity analysis. Methods: Treatment-naive PCV eyes undergoing OCT and indocyanine green angiography (ICGA) at baseline and posttreatment were included. Two graders confirmed diagnosis and identified posttreatment complete or incomplete regression on ICGA. Two other graders classified OCT characteristics of pigment epithelial detachment (PED) (polypoidal lesion) based on 5 prespecified features: "A," no PED; "B," PED with internal homogeneous reflectivity with predominant "BUN" (blended retinal pigment epithelium with underlying structure) sign; "C," PED with internal homogeneous reflectivity with minimal "BUN"; "D," heterogeneous PED; and "E," PED with hyporeflectivity. Results: Among 130 polypoidal lesions (65 pretreatment and 65 posttreatment) of 39 PCV eyes (39 patients; 54% female; mean age±SD: 64.6±8.2), all pretreatment lesions showed feature D on OCT. Posttreatment lesions with complete regression (31 lesions) showed OCT features A, B, C, D, and E in 32%, 45%, 13%, 10%, and 0%, respectively. Posttreatment lesions with incomplete regression (34 lesions) showed OCT features A, B, C, D, and E in 0%, 6%, 15%, 79%, and 0%, respectively. Presence of either feature A or B had highest accuracy (86%; 95% confidence interval: 75%-93%); 77% sensitivity; 94% specificity; RR 5.0 (3.5-7.1, P<0.001) for complete regression. Presence of feature D had highest accuracy (85%; 95% confidence interval: 74%-92%); 79% sensitivity; 90% specificity; RR 4.6 (3.0-6.9, P<0.001) for incomplete regression. Conclusions: Without ICGA, OCT features could provide high accuracy in identifying posttreatment complete or incomplete polypoidal regression in PCV.

Original languageEnglish (US)
Pages (from-to)408-416
Number of pages9
JournalAsia-Pacific Journal of Ophthalmology
Volume11
Issue number5
DOIs
StatePublished - Sep 15 2022

Keywords

  • age-related macular degeneration
  • complete polypoidal regression
  • indocyanine green angiography
  • optical coherence tomography
  • polypoidal choroidal vasculopathy

ASJC Scopus subject areas

  • Ophthalmology

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