Polypoidal choroidal vasculopathy versus neovascular age related macular degeneration: a comparison of demographics, clinical presentation, and treatment outcomes in Nigerians

Abstract

Purpose: To compare the demographics, clinical presentation, and outcomes of intravitreal (IV) anti-VEGF monotherapy in the management of treatment-naïve polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (nAMD) in Nigerians. Methods: This is a retrospective, interventional, comparative study. Data obtained from consecutively treated PCV and nAMD patients include age, sex, laterality, symptom duration, LogMAR visual acuity (pre- & post-treatment), occurrence of vitreous hemorrhage, optical coherence tomography central macular thickness (CMT), and duration of clinic visits. Data was analyzed using IBM SPSS version 22.0, P PCV (38% versus 19%) p = 0.036. Vitreous hemorrhage: more common in PCV (42% versus 19%) p = 0.001. nAMD patients had poorer baseline vision (LogMAR 1.4 versus LogMAR 1.2) p = 0.2, thicker maculae (361 microns versus 331 microns), and received more mean intravitreal anti-VEGF injections (4 versus 3). Visual and anatomical outcomes were better for PCV; final vision (LogMAR 0.89 versus LogMAR 1.04), p = 0.064, final CMT (247 microns versus 331 microns), p = 0.05. nAMD patients had higher rate of >12 months follow-up (57.6% versus 35.0%) p = 0.002. Conclusion: Demographic and clinical differences exist between PCV and nAMD. Though chronic presentation for both diseases is common, treatment improves vision and anatomy in most patients, moreso in PCV. Earlier treatment will likely yield better outcomes.

Keywords

• Polypoidal choroidal vasculopathy
• Neovascular age related macular degeneration
• Anti-vascular endothelial growth factor
• Black Africans
• Optical coherence tomography