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Characteristic appearances of fundus autofluorescence in treatment-naive and active polypoidal choroidal vasculopathy: a retrospective study of 170 patients

  • Retinal Disorders
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Abstract

Purpose

To investigate the characteristic appearances of fundus autofluorescence (FAF) in patients with treatment-naive and active polypoidal choroidal vasculopathy (PCV).

Method

Cases with the diagnosis of treatment-naive and active PCV from November 2012 to May 2017 at Peking Union Medical College Hospital were retrospectively reviewed. All patients underwent comprehensive ophthalmologic examination. Autofluorescence (AF) findings were described at the retinal sites of the corresponding lesions identified and diagnosed using indocyanine green angiography and spectral-domain optical coherence tomography.

Results

One hundred seventy patients with 192 affected eyes were included. The logMAR BCVA of the patients were 0.53 ± 0.28. The six AF patterns of 243 polypoidal lesions were confluent hypo-AF with hyper-AF ring (49.8%), confluent hypo-AF (22.6%), hyper-AF with hypo-AF ring (3.7%), granular hypo-AF (7.0%), blocked hypo-AF due to hemorrhage (8.6%), and polyps without apparent AF changes (8.2%). For 146 branching vascular networks (BVNs), 97.3% were granular hypo-AF, and others were blocked hypo-AF due to hemorrhage.

Conclusion

In eyes with treatment-naive and active PCV, the polypoidal lesions and BVNs induce characteristic FAF changes. FAF images provide reliable adjunct reference for the diagnosis of PCV.

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References

  1. Yannuzzi LA, Sorenson J, Spaide RF, Lipson B (1990) Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina 10(1):1–8

    Article  PubMed  CAS  Google Scholar 

  2. Yannuzzi LA, Ciardella A, Spaide RF, Rabb M, Freund KB, Orlock DA (1997) The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol 115(4):478–485

    Article  PubMed  CAS  Google Scholar 

  3. Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA (1995) Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina 15(2):100–110

    Article  PubMed  CAS  Google Scholar 

  4. Klaver CC, Wolfs RC, Vingerling JR, Hofman A, de Jong PT (1998) Age-specific prevalence and causes of blindness and visual impairment in an older population: the Rotterdam Study. Arch Ophthalmol 116(5):653–658

    Article  PubMed  CAS  Google Scholar 

  5. Lorentzen TD, Subhi Y, Sørensen TL. (2017) Prevalence of polypoidal choroidal vasculopathy in white patients with exudative age-related macular degeneration: systematic review and meta-analysis. Retina. https://doi.org/10.1097/IAE.0000000000001872

  6. Sho K, Takahashi K, Yamada H, Wada M, Nagai Y, Otsuji T, Nishikawa M, Mitsuma Y, Yamazaki Y, Matsumura M, Uyama M (2003) Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol 121(10):1392–1396

    Article  PubMed  Google Scholar 

  7. Wen F, Chen C, Wu D, Li H (2004) Polypoidal choroidal vasculopathy in elderly Chinese patients. Graefes Arch Clin Exp Ophthalmol 242(8):625–629

    Article  PubMed  Google Scholar 

  8. Liu Y, Wen F, Huang S, Luo G, Yan H, Sun Z, Wu D (2007) Subtype lesions of neovascular age-related macular degeneration in Chinese patients. Graefes Arch Clin Exp Ophthalmol 245(10):1441–1445

    Article  PubMed  Google Scholar 

  9. Maruko I, Iida T, Saito M, Nagayama D, Saito K (2007) Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 144(1):15–22

    Article  PubMed  Google Scholar 

  10. Koh AH, Chen LJ, Chen SJ, Chen SJ, Chen Y, Giridhar A, Iida T, Kim H, Yuk Yau Lai T, Lee WK, Li X, Han Lim T, Ruamviboonsuk P, Sharma T, Tang S, Yuzawa M (2013) Polypoidal choroidal vasculopathy: evidence-based guidelines for clinical diagnosis and treatment. Retina 33(4):686–716

    Article  PubMed  Google Scholar 

  11. Wong RL, Lai TY (2013) Polypoidal choroidal vasculopathy: an update on therapeutic approaches. J Ophthalmic Vis Res 8(4):359–371

    PubMed  PubMed Central  Google Scholar 

  12. Oztas Z, Sigford DK, Tezel TH (2016) Characteristics of fundus autofluorescence in active polypoidal choroidal vasculopathy. Turk J Ophthalmol 46(4):165–168

    Article  PubMed  PubMed Central  Google Scholar 

  13. Delori FC, Dorey CK, Staurenghi G, Arend O, Goger DG, Weiter JJ (1995) In vivo fluorescence of the ocular fundus exhibits retinal pigment epithelium lipofuscin characteristics. Invest Ophthalmol Vis Sci 36(3):718–729

    PubMed  CAS  Google Scholar 

  14. von Ruckmann A, Fitzke FW, Bird AC (1997) Fundus autofluorescence in age-related macular disease imaged with a laser scanning ophthalmoscope. Invest Ophthalmol Vis Sci 38(2):478–486

    Google Scholar 

  15. von Ruckmann A, Fitzke FW, Bird AC (1995) Distribution of fundus autofluorescence with a scanning laser ophthalmoscope. Br J Ophthalmol 79(5):407–412

    Article  Google Scholar 

  16. Schmitz-Valckenberg S, Holz FG, Bird AC, Spaide RF (2008) Fundus autofluorescence imaging: review and perspectives. Retina 28(3):385–409

    Article  PubMed  Google Scholar 

  17. Suetsugu T, Kato A, Yoshida T, Yasukawa T, Nishiwaki A, Hasegawa N, Usui H, Ogura Y (2016) Evaluation of peripheral fundus autofluorescence in eyes with wet age-related macular degeneration. Clin Ophthalmol 10:2497–2503

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ozkok A, Sigford DK, Tezel TH (2016) Patterns of fundus autofluorescence defects in neovascular age-related macular degeneration subtypes. Retina 36(11):2191–2196

    Article  PubMed  Google Scholar 

  19. Yamagishi T, Koizumi H, Yamazaki T, Kinoshita S (2014) Changes in fundus autofluorescence after treatments for polypoidal choroidal vasculopathy. Br J Ophthalmol 98(6):780–784

    Article  PubMed  Google Scholar 

  20. Yamagishi T, Koizumi H, Yamazaki T, Kinoshita S (2012) Fundus autofluorescence in polypoidal choroidal vasculopathy. Ophthalmology 119(8):1650–1657

    Article  PubMed  Google Scholar 

  21. Suzuki M, Gomi F, Sawa M, Ueno C, Nishida K (2013) Changes in fundus autofluorescence in polypoidal choroidal vasculopathy during 3 years of follow-up. Graefes Arch Clin Exp Ophthalmol 251(10):2331–2337

    Article  PubMed  Google Scholar 

  22. Hikichi T, Kitamei H, Shioya S (2016) Retinal pigment epithelial atrophy over polypoidal choroidal vasculopathy lesions during ranibizumab monotherapy. BMC Ophthalmol 16(1):55

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Kuroda Y, Yamashiro K, Tsujikawa A, Ooto S, Tamura H, Oishi A, Nakanishi H, Miyake M, Yoshikawa M, Yoshimura N (2016) Retinal pigment epithelial atrophy in neovascular age-related macular degeneration after ranibizumab treatment. Am J Ophthalmol 161:94–103

    Article  PubMed  CAS  Google Scholar 

  24. McBain VA, Townend J, Lois N (2007) Fundus autofluorescence in exudative age-related macular degeneration. Br J Ophthalmol 91(4):491–496

    Article  PubMed  Google Scholar 

  25. Lafaut BA, Bartz-Schmidt KU, Vanden BC, Aisenbrey S, De Laey JJ, Heimann K (2000) Clinicopathological correlation in exudative age related macular degeneration: histological differentiation between classic and occult choroidal neovascularisation. Br J Ophthalmol 84(3):239–243

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Sato T, Kishi S, Watanabe G, Matsumoto H, Mukai R (2007) Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy. Retina 27(5):589–594

    Article  PubMed  Google Scholar 

  27. Tsujikawa A, Hirami Y, Nakanishi H, Ojima Y, Aikawa H, Tamura H, Otani A, Yoshimura N (2007) Pigment epithelial detachment in polypoidal choroidal vasculopathy. Am J Ophthalmol 143(1):102–111

    Article  PubMed  Google Scholar 

  28. Ojima Y, Hangai M, Sakamoto A, Tsujikawa A, Otani A, Tamura H, Yoshimura N (2009) Improved visualization of polypoidal choroidal vasculopathy lesions using spectral-domain optical coherence tomography. Retina 29(1):52–59

    Article  PubMed  Google Scholar 

  29. Nakashizuka H, Mitsumata M, Okisaka S, Shimada H, Kawamura A, Mori R, Yuzawa M (2008) Clinicopathologic findings in polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci 49(11):4729–4737

    Article  PubMed  Google Scholar 

  30. Tanaka K, Mori R, Kawamura A, Nakashizuka H, Wakatsuki Y, Yuzawa M (2017) Comparison of OCT angiography and indocyanine green angiographic findings with subtypes of polypoidal choroidal vasculopathy. Br J Ophthalmol 101(1):51–55

    Article  PubMed  Google Scholar 

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Acknowledgements

We also thank Yanjun Xie for collecting the medical records. Additionally, Xinyu Zhao wants to thank, in particular, the invaluable support received from Shengzhi Liu over the years.

Funding

No funding was received for this research.

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Authors and Affiliations

Authors

Contributions

Xin-yu Zhao carried out the entire procedure including the collection of medical records, image evaluation, statistical analysis, drafting the manuscript, and manuscript revision. You-xin Chen conceived of the study, coordinated and participated in the entire process of drafting, and revised the manuscript. Song Xia contributed to image evaluation and manuscript revision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Youxin Chen.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Note: No portion of the contents of this paper has been published previously.

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Cite this article

Zhao, X., Xia, S. & Chen, Y. Characteristic appearances of fundus autofluorescence in treatment-naive and active polypoidal choroidal vasculopathy: a retrospective study of 170 patients. Graefes Arch Clin Exp Ophthalmol 256, 1101–1110 (2018). https://doi.org/10.1007/s00417-018-3980-2

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  • DOI: https://doi.org/10.1007/s00417-018-3980-2

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