Incidence and risk factors for progression of pachychoroid disease spectrum

Abstract

<h3>Purpose: </h3><p>To report the 1-year progression rate and associated risk factors in an Asian cohort of patients with pachychoroid disease spectrum (PDS) phenotype.</p><h3>Methods: </h3><p>We report the 1-year findings from a prospective observational study recruiting subjects with subfoveal choroidal thickness (SFCT) of ≥300μm. Each eye was evaluated at baseline and month 12 according to a standardized protocol including visual acuity and multimodal imaging.</p><h3>Results: </h3><p>A total of 223 eyes of 133 participants (mean age 59.23 ± 9.18 years, 27.1% female) finished 1-year follow-up. Distribution of baseline diagnosis was: uncomplicated pachychoroid (43 eyes), pachychoroid pigment epitheliopathy (PPE) 108 eyes, CSCR (54 eyes) and pachychoroid neovasculopathy (18 eyes). There was no significant change in mean best corrected visual acuity or subfoveal choroidal thickness (SFCT). Fourteen eyes (6.3%) evolved to a different PDS diagnosis, but there was no significant change in mean BCVA LogMAR 0.15 ± 0.18 (Snellen equivalent 20/30) vs 0.07 ± 0.11 (Snellen equivalent 20/25), (p=0.18) or SFCT (426.8 ± 59.2 vs 456.3 ± 89.5, p=0.49). Incident neovascularization developed in 8 eyes (3.6%, 5 from PPE, 3 from CSCR). Seven patients received treatment (3 anti-VEGF, 4 photodynamic therapy). Factors associated with developing neovascularization include older age, smoking and the presence of shallow irregular RPE elevation (SIRE) on optical coherence tomography (OCT).</p><h3>Conclusion: </h3><p>At 1 year, PDS remains relatively stable with low progression rate. Older age,smoking and the presence of SIRE were associated with higher rates of neovascular complications.</p>