Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification system

AIM: To classify polypoidal choroidal vasculopathy (PCV) into 2 subtypes based on the subfoveal choroidal thickness (SFCT) and to further evaluate their multimodal image features. METHODS: A retrospective observational case series study. Sixty-four eyes of 64 patients with PCV were enrolled and cla...

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Main Authors: Zi-Yang Liu, Bing Li, Song Xia, You-Xin Chen
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2020-05-01
Series:International Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.cn/en_publish/2020/5/20200506.pdf
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author Zi-Yang Liu
Bing Li
Song Xia
You-Xin Chen
author_facet Zi-Yang Liu
Bing Li
Song Xia
You-Xin Chen
author_sort Zi-Yang Liu
collection DOAJ
description AIM: To classify polypoidal choroidal vasculopathy (PCV) into 2 subtypes based on the subfoveal choroidal thickness (SFCT) and to further evaluate their multimodal image features. METHODS: A retrospective observational case series study. Sixty-four eyes of 64 patients with PCV were enrolled and classified into 2 groups based on SFCT (thick-choroid group/thin-choroid group). Then further analyze the spectrum domain optical coherence tomography (SD-OCT) and indocyanine green angiography (ICGA) differences of the two subtypes. Imaging analysis included measurement of SFCT, maximum vascular diameter ratio (MVDR), choroidal vascularity index (CVI), central macular thickness (CMT), and the presence of pigment epithelial detachment (PED) on SD-OCT. Polypoidal lesions (polyps) number, branching vascular network (BVN) area, greatest linear dimension (GLD), and the choroidal vascular hyperpermeability (CVH) were analyzed by ICGA. RESULTS: The distribution of SFCT was bimodal with two peaks at 195 and 285 μm, and a trough at 225 μm. The 225 μm was taken as the cutoff point for the following classification of thick/thin choroid groups. The PCV eyes in the thick-choroid group presented with greater MVDR, CVI within 3 and 6 mm of the fovea, but lower CMT, less PED, small PED diameters on SD-OCT scans, and fewer polyps, smaller BVN and GLD, but more frequency of CVH on ICGA. CONCLUSION: The SFCT at 225 μm can be used as a readily available indicator for the classification of PCV subtypes. The thick-choroid group presents much apparent enlargement of the choroidal layer and vasculature expansion, which indicates different pathogenesis of the two subtypes.
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spelling doaj.art-6a53da4fd6744bbab59b16c1c8167c412022-12-22T01:25:18ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982020-05-0113573173610.18240/ijo.2020.05.06Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification systemZi-Yang Liu0Bing Li1Song Xia2You-Xin Chen3Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, ChinaDepartment of Ophthalmology, Guizhou Provincial People’s Hospital, Guiyang 550002, Guizhou Province, ChinaDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, ChinaAIM: To classify polypoidal choroidal vasculopathy (PCV) into 2 subtypes based on the subfoveal choroidal thickness (SFCT) and to further evaluate their multimodal image features. METHODS: A retrospective observational case series study. Sixty-four eyes of 64 patients with PCV were enrolled and classified into 2 groups based on SFCT (thick-choroid group/thin-choroid group). Then further analyze the spectrum domain optical coherence tomography (SD-OCT) and indocyanine green angiography (ICGA) differences of the two subtypes. Imaging analysis included measurement of SFCT, maximum vascular diameter ratio (MVDR), choroidal vascularity index (CVI), central macular thickness (CMT), and the presence of pigment epithelial detachment (PED) on SD-OCT. Polypoidal lesions (polyps) number, branching vascular network (BVN) area, greatest linear dimension (GLD), and the choroidal vascular hyperpermeability (CVH) were analyzed by ICGA. RESULTS: The distribution of SFCT was bimodal with two peaks at 195 and 285 μm, and a trough at 225 μm. The 225 μm was taken as the cutoff point for the following classification of thick/thin choroid groups. The PCV eyes in the thick-choroid group presented with greater MVDR, CVI within 3 and 6 mm of the fovea, but lower CMT, less PED, small PED diameters on SD-OCT scans, and fewer polyps, smaller BVN and GLD, but more frequency of CVH on ICGA. CONCLUSION: The SFCT at 225 μm can be used as a readily available indicator for the classification of PCV subtypes. The thick-choroid group presents much apparent enlargement of the choroidal layer and vasculature expansion, which indicates different pathogenesis of the two subtypes.http://www.ijo.cn/en_publish/2020/5/20200506.pdfpolypoidal choroidal vasculopathyspectral-domain optical coherence tomographyindocyanine green angiographysubfoveal choroidal thickness
spellingShingle Zi-Yang Liu
Bing Li
Song Xia
You-Xin Chen
Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification system
International Journal of Ophthalmology
polypoidal choroidal vasculopathy
spectral-domain optical coherence tomography
indocyanine green angiography
subfoveal choroidal thickness
title Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification system
title_full Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification system
title_fullStr Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification system
title_full_unstemmed Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification system
title_short Analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy: a new classification system
title_sort analysis of choroidal morphology and comparison of imaging findings of subtypes of polypoidal choroidal vasculopathy a new classification system
topic polypoidal choroidal vasculopathy
spectral-domain optical coherence tomography
indocyanine green angiography
subfoveal choroidal thickness
url http://www.ijo.cn/en_publish/2020/5/20200506.pdf
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