The relationship between pigment epithelial detachment and visual outcome in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

• Published in: Eye (London) 2020-12, Vol.34 (12), p.2257-2263
• Main Authors: Cheong, Kai Xiong, Grewal, Dilraj Singh, Teo, Kelvin Yi Chong, Gan, Alfred Tau Liang, Jaffe, Glenn Jay, Cheung, Gemmy Chui Ming
• Format: Article
• Language: English
• Subjects: 692/53/2423; 692/700/1421; Acuity; Age; Cholesterol; Epithelium; Eye; Laboratory Medicine; Macular degeneration; Medicine; Medicine & Public Health; Morphology; Multivariate analysis; Ophthalmology; Pharmaceutical Sciences/Technology; Photopigments; Retinal pigment epithelium; Surgery; Surgical Oncology; Vascular diseases
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/s41433-020-0803-6

Background/objectives To compare the detailed optical coherence tomography (OCT)-based morphological parameters of pigment epithelial detachment (PED) in eyes presenting with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV), and to assess whether these PED-associated parameters influence 1-year visual outcomes. Subject/methods We analysed images from a prospective observational study of treatment-naive Asian participants with nAMD or PCV. An independent reading centre graded baseline morphological features of PED on spectral-domain OCT, including greatest height, greatest width, greatest volume, morphology (predominantly dome shaped versus peaked), presence of retinal pigment epithelium (RPE) tear and cholesterol bands. The influence of these baseline features on 12 months best corrected visual acuity (BCVA) was evaluated. Results Seventy-eight eyes of 78 participants with PED were studied. In total, 40 (51.3%) participants had nAMD and 38 (48.7%) had PCV. Eyes with PCV, compared with nAMD, had PED of greater height (455.9 µm versus 389.9 µm; P  = 0.035) and had higher prevalence of RPE tear (22.9 versus 5.3%; P  = 0.041). In the multivariate analysis, only baseline BCVA was significantly associated with month 12 BCVA, but none of the PED-associated OCT parameters at baseline influenced month 12 BCVA. Conclusions Despite the differences in PED height and prevalence of RPE tear between nAMD and PCV, none of these PED morphological factors on OCT at baseline significantly influenced visual outcome at 12 months.