TRANSMACULAR PACHYVESSELS BENEATH POLYPOIDAL CHOROIDAL VASCULOPATHY LESIONS PREDICT LATER RECURRENCE.

PURPOSE: To investigate the relationship between the spatial arrangement of pachyvessels and polypoidal choroidal vasculopathy (PCV) lesions in relation to recurrence.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.