OCT Baseline Features To Predict Theefficacy Of The Combination Of PDT And Anti VEGF In The Treatment Of Polypoid Choroidal Vascular Lesions

Objective:To investigate the relationship between optical coherence tomography(OCT)baseline features and the efficacyof photodynamic therapy(PDT)combined antivascular endothelial growth factor(anti-VEGF)drugs in the treatment of polypoidal choroidal vasculopathy(PCV).Methods:In this study,32 cases(14 males and 18 females)with PCV were retrospectively analyzed,with a total of 32 eyes.All patients were initially treated with PDT combined with anti VEGF drugs(rezumumab or conbercept)plus subsequent anti VEGF drug PRN.The follow-up time was at least 3 months.According to the improvement of the best corrected visual acuity at the end of the follow-up,the patients were divided into two groups : The better curative effect group(Snellen vision improvement was equal or greater than 1 lines,16 cases)and poor curative effect group(Snellen visual improvement less than 1 lines,16 cases).Record all OCT characteristics of patients before treatment: positive rate of hyperreflective above retinal pigment epithelium,double-layer sign(DLS),neurosensory retinal detachment(NRD)and interretinal cystoid fluid(IRC).Statistical analysis of the relationship between the baseline features of OCT and the prognosis of the visual acuity(logMAR vision)of the patients.Results: The average BCVA before and after treatment were as follows: better curative effect group 0.83 ± 0.39 logMAR,0.46 ±0.27logMAR(p=0.000);poor curative effect group 0.95 ± 0.42 logMAR,0.89 ± 0.360logMAR(p=0.07);central macular thickness(CMT): better curative effect group 403.06± 96.55?m,208.94 ± 62.12?m(p=0.000);poor curative effect group 456.63 ± 111.58?m 283.88 ± 107.30?m(p=0.000);the average number of injections were: better curative effect group 1.94 ± 0.77,poor curative effect group 3.13 ± 2.16.Comparison of better curative effect group and poor curative effect group,the positive rate of hyperreflective above RPE were 31.3% and 81.3%(p=0.011);the positive rate of IRC were 12.5% and 56.3%(p=0.023)respectively.The positive rate of hyperreflective above RPE and IRC in the better curative effect group was significantly lower than that in the poor curative effect group,while the positive rate of DLS in the better curative effect group was significantly higher than that in the poor curative effect group: 87.5% vs 43.8%(p=0.023);the positive rate of NRD in the two groups was 100% and 87.5% respectively(p=0.484),and the difference was not statistically significant.Conclusions: the baseline features of OCT can predict the prognosis of PCV patients.hyperreflective above RPE and IRC indicate that the curative effect of combined treatment is poor,but DLS indicates that the curative effect of combined treatment is better.