Posttreatment polyp regression and risk of massive submacular hemorrhage in eyes with polypoidal choroidal vasculopathy

Joon Hee Cho, Young Joo Park, Soo Chang Cho, Na Kyung Ryoo, Kwan Hyuk Cho, Sang Jun Park, Kyu Hyung Park, Se Joon Woo

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25 Scopus citations

Abstract

Purpose:To study the association between the risk of massive submacular hemorrhage (SMH) and polyp regression after initial treatment of polypoidal choroidal vasculopathy using long-term follow-up data.Methods:Retrospective study of 223 patients who were diagnosed with polypoidal choroidal vasculopathy and were followed up for up to 11 years. Subjects were categorized into "regression" and "no regression" groups, according to their polyp status after the initial treatment. Kaplan-Meier survival analyses were performed on development of massive SMH. The association between treatment methods and the occurrence of massive SMH was also analyzed.Results:The incidence rates of massive SMH at 3, 6, and 9 years in the "no regression" group were 6.50, 22.59, and 38.03%, respectively, and in the "regression" group were 1.14, 6.47, and 10.92%, respectively (P = 0.005, log-rank test). The hazard ratio of massive SMH was 3.677 for cluster-type polyps and 0.271 for polyp regression after initial treatment. A higher rate of polyp regression was associated with photodynamic therapy (PDT) than anti-VEGF monotherapy (64.4 vs. 33.3%, P < 0.001). Additional anti-VEGF treatments after initial PDT showed lower risk of massive SMH than PDT only. (9.5 vs 38.5%, P = 0.005).Conclusion:The long-term risk of massive SMH after initial treatment on polypoidal choroidal vasculopathy is significantly higher in eyes with persistent polyps than those with regressed polyps. Ophthalmologists should pay attention to the risk of massive SMH and the polyp status when treating polypoidal choroidal vasculopathy.

Original languageEnglish
Pages (from-to)468-476
Number of pages9
JournalRetina
Volume40
Issue number3
DOIs
StatePublished - 1 Mar 2020

Bibliographical note

Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • age-related macular degeneration
  • indocyanine green angiography
  • optical coherence tomography
  • polyp regression
  • polypoidal choroidal vasculopathy
  • submacular hemorrhage
  • subretinal hemorrhage
  • survival analysis

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