TRANSMACULAR PACHYVESSELS BENEATH POLYPOIDAL CHOROIDAL VASCULOPATHY LESIONS PREDICT LATER RECURRENCE.

Abstract

To investigate the relationship between the spatial arrangement of pachyvessels and polypoidal choroidal vasculopathy (PCV) lesions in relation to recurrence. This retrospective study included 58 eyes of 58 patients with treatment-naive PCV who were followed for at least 1 year after receiving anti-vascular endothelial growth factor injections, with or without photodynamic therapy. Using en face optical coherence tomography, the eyes were categorized into 2 groups based on the presence or absence of transmacular pachyvessels passing beneath PCV lesions (polypoidal lesions or branching neovascular networks). The primary outcome was the recurrence rate of PCV within 1 year. Of the 58 eyes, 35 (60.3%) had pachyvessels located beneath PCV lesions. The 1-year recurrence rate was significantly higher in eyes with pachyvessels than without (71.4% vs. 39.1%, P = 0.017). Univariable logistic regression analysis identified the presence of pachyvessels beneath lesions as a significant predictor (odds ratio, 3.89; 95% confidence interval, 1.28-11.84; P = 0.017). This remained the only significant predictor of recurrence within 1 year on multivariable logistic regression (odds ratio, 3.84; 95% confidence interval, 1.22-12.09; P = 0.022). The presence of transmacular pachyvessels may serve as a novel biomarker to predict prognosis and guide individualized treatment strategies for patients with PCV. These findings suggest that the anatomical relationship between pachyvessels and PCV lesions could be a critical factor in treatment response.