Objective: To observe the natural course and evaluate the prognostic factors influencing the follow-up visual acuity of polypoidal choroidal vasculopathy (PCV).
Methods: It was a retrospective case series. Forty-five consecutive patients (51 eyes) who were diagnosed with PCV by fundus photography, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were followed up with (11.1 ± 2.0) months (mean ± SD). Age, baseline visual acuity, the presence of pigment epithelium detachment (PED), lesion size, the polypoidal lesions involving the fovea and the regression of polypoidal lesions were recorded. Multi-factor regression analysis of visual acuity at follow up was applied with SPSS 16.0 statistics software.
Results: Among the 45 patients (51 eyes), the hemorrhage or exudation were increased in 15 eyes (29.4%), decreased in 25 eyes (49.0%), 5 eyes (9.8%) developed macula scar and 6 eyes (11.8%) macula atrophy. During the follow-up period, the visual acuity was improved in 11 eyes (21.6%), stable in 21 (41.2%) and regressed in 19 (37.2%). Twenty-five eyes (49.0%) demonstrated polypoidal lesions involving the fovea and 26 eyes (51.0%) did not. ICGA revealed that the polypoidal lesions were unchanged in 18 eyes (35.3%), regressed in 13 (25.5%), grew in 13 (25.5%), and mixed in 7 eyes (13.7%). The changes of visual acuity at follow up were related to the age, baseline visual acuity, and polypoidal lesions involving in the fovea (b = -0.005, 0.382 and -0.430; P = 0.034, 0.000 and 0.000). Improvement of visual acuity at follow up was related to the regression of polypoidal lesions (b = 2.259, P = 0.019, OR = 9.578).
Conclusions: There is a large variation in the visual prognosis in Chinese patients with PCV. The presence of PED and the lesion size had no effect on the visual prognosis of PCV. Better visual acuity during follow-up period is correlated with younger age, better baseline visual acuity, polypoidal lesions not involving the fovea and a regression of polypoidal lesions.