Changes of fundus autofluorescence in polypoidal choroidal vasculopathy before and after intravitreal ranibizumab injections_Chinese Journal of Ocular Fundus Diseases

Authors：

 Zhang Ximei , Xu Xiaoli , Li Jie , Xie Juan , Zheng Dongping

Shanxi Eye Hospital, Taiyuan 030002, China (Xu Xiaoli, graduate student, now working at the Department of Ophthalmology, Kunming First People’s Hospital);

Corresponding author：

Zhang Ximei, Email: ximeizhang@sina.cn

Keywords：

Choroid diseases; Angiogenesis inhibitors; Ranibizumab

DOI：

10.3760/cma.j.issn.1005-1015.2017.06.008

Video：

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Objective To observe the characteristics of fundus autofluorescence (FAF) in patients with polypoidal choroidal vasculopathy (PCV) before and after intravitreal ranibizumab injections. Methods A retrospective case series. Seventeen patients (17 eyes) including 11 males and 6 females were enrolled in this study. Best corrected visual acuity (BCVA), FAF and indocyanine green angiography examination were performed on all eyes. The eyes were divided into hypo-autofluorescence group (8 eyes) and mixed autofluorescence group (9 eyes) according to the fluorescence degree. There was no differences of BCVA between two groups (t=2.403, P=0.072).All eyes received monthly intravitreal ranibizumab injections for 3 months followed by an as-needed reinjection schedule. All eyes were followed up for 12 months. FAF was performed at the 3rd, 6th and 12th month after first treatment. The changes of FAF characteristics and BCVA before and after treatment were observed. Results Before the treatment, the PCV lesions showed two distinct FAF patterns: the confluent hypo-autofluorescence at the polypoidal lesions and the granular hypo-autofluorescence at branching choroidal vascular networks (BVN). During the treatment, the abnormal FAF area of the whole lesions in all eyes reduced and gradually returned to normal. At the 3rd month after treatment, the central hypo-autofluorescence of polyps was surrounded by a hyper-autofluorescence ring, and with time, the ring was weakened or eliminated. However, all the hypo-autofluorescence findings in BVN at baseline were unchanged during the follow-up period. There was no significant differences in BCVA between hypo-autofluorescence group and hyper-autofluorescence group at different follow-up times (t=2.674, 2.862, 2.250; P=0.058, 0.052, 0.081). At final follow-up, 5 eyes (62.5%) in hypo-autofluorescence group and 3 eyes (33.3%) in hyper-autofluorescence group had increased BCVA, the different was not significant (P=0.347). Conclusions Before the treatment, there were the central hypo-autofluorescence of polyps and circumferential hypo-autofluorescence ring or confluent hypo-autofluorescence. After the treatment, the autofluorescence of polyps increased and then gradually returned to normal.

Citation： Zhang Ximei, Xu Xiaoli, Li Jie, Xie Juan, Zheng Dongping. Changes of fundus autofluorescence in polypoidal choroidal vasculopathy before and after intravitreal ranibizumab injections. Chinese Journal of Ocular Fundus Diseases, 2017, 33(6): 587-592. doi: 10.3760/cma.j.issn.1005-1015.2017.06.008 Copy

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2.	Maruko I, Iida T, Saito M, et al. Clinical characteristics of exudative age-related macular degeneration in Japanese patients[J]. Am J Ophthalmol, 2007, 144(1): 15-22. DOI: 10.1016/j.ajo.2007.03.047.
3.	Liu Y, Wen F, Huang S, et al. Subtype lesions of neovascular age-related macular degeneration in Chinese patients[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245(10): 1441-1445. DOI: 10.1007/s00417-007-0575-8.
4.	Laude A, Cacketta PD, Vithanac EN, et al. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease?[J]. Prog Retin Eye Res, 2010, 29(1): 19-29. DOI: 10.1016/j.preteyeres.2009.10.001.
5.	Imamura Y, Engelbert M, Iida T, et al. Polypoidal choroidal vasculopathy: a review[J]. Surv Ophthalmol, 2010, 55(6): 501-515. DOI: 10.1016/j.survophthal.2010.03.004.
6.	徐晓莉, 张喜梅.眼底自发荧光技术在湿性年龄相关性黄斑变性诊断中的应用[J]. 国际眼科纵览, 2015, 39(1): 25-29. DOI: 10.3706/cma.j.issn.1673-5803.2015.01.005.Xu XL, Zhang XM. Application of fundus autofluorescence in diagnosis of wet age-related macular degeneration[J]. Int Rev Ophthalmol, 2015, 39(1): 25-29. DOI: 10.3706/cma.j.issn.1673-5803.2015.01.005.
7.	Yamagishi T, Koizumi H, Yamazaki T, et al. Changes in fundus autofluorescence after treatments for polypoidal choroidal vasculopathy[J]. Br J Ophthalmol, 2014, 98(6): 780-784. DOI: 10.1136/bjophthalmol-2013-303739.
8.	Suzuki M, Gomi F, Sawa M, et al. Changes in fundus autofuorescence in polypoidal choroidal vasculopathy during 3 years of follow-up[J]. Graefe's Arch Clin Exp Ophthalmol, 2013, 251(10): 2331-2337. DOI: 10.1007/s00417-013-2336-1.
9.	Yamagishi T, Koizumi H, Yamazaki T, et al. Fundus autofuorescence in polypoidal choroidal vasculopathy[J]. Ophthalmology, 2012, 119(8): 1650-1657. DOI: 10.1016/j.ophtha.2012.02.016.
10.	Ojima Y, Hangai M, Sakamoto A, et al. Improved visualization of polypoidal choroidal vasculopathy lesions using spectral-domain optical coherence tomography[J]. Retina, 2009, 29(1): 52-59. DOI: 10.1097/IAE.0b013e3181884fbf.
11.	Sato T, Kishi S, Watanabe G, et al. Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy[J]. Retina, 2007, 27(5): 589-594. DOI: 10.1097/01.iae.0000249386.63482.05.
12.	Holz FG, Bindewald-Wittich A, Fleckenstein M, et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration[J]. Am J Ophthalmol, 2007, 143(3): 463-472. DOI: 10.1016/j.ajo.2006.11.041.
13.	Hikichi T, Higuchi M, Matsushita T, et al. One-year results of three monthly ranibizumab injections and as-needed reinjections for polypoidal choroidal vasculopathy in Japanese patients[J]. Am J Ophthalmol, 2012, 154(1): 117-124. DOI: 10.1016/j.ajo.2011.12.019.
14.	Nakashizuka H, Mitsumata M, Okisaka S, et al. Clinicopathologic findings in polypoidal choroidal vasculopathy[J]. Invest Ophthalmol Vis Sci, 2008, 49(11): 4729-4737. DOI: 10.1167/iovs.08-2134.
15.	Schmitz-Valckenberg S, Holz FG, Bird AC, et al. Fundus autofuorescence imaging: review and perspectives[J]. Retina, 2008, 28(3): 385-409. DOI: 10.1097/IAE.0b013e318164a907.
16.	Akaza E, Yuzawa M, Mori R. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy[J]. Jpn J Ophthalmol, 2011, 55(1): 39-44. DOI: 10.1007/s10384-010-0886-x.
17.	Saito M, Iida T, Kano M. Intravitreal ranibizumab for polypoidal choroidal vasculopathy with recurrent or residual exudation[J]. Retina, 2011, 31(8): 1589-1597. DOI: 10.1097/IAE.0b013e31820f4b21.

1. Wen F, Chen C, Wu D, et al. Polypoidal choroidal vasculopathy in elderly Chinese patients[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(8): 625-629. DOI: 10.1007/s00417-003-0667-z.
2. Maruko I, Iida T, Saito M, et al. Clinical characteristics of exudative age-related macular degeneration in Japanese patients[J]. Am J Ophthalmol, 2007, 144(1): 15-22. DOI: 10.1016/j.ajo.2007.03.047.
3. Liu Y, Wen F, Huang S, et al. Subtype lesions of neovascular age-related macular degeneration in Chinese patients[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245(10): 1441-1445. DOI: 10.1007/s00417-007-0575-8.
4. Laude A, Cacketta PD, Vithanac EN, et al. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease?[J]. Prog Retin Eye Res, 2010, 29(1): 19-29. DOI: 10.1016/j.preteyeres.2009.10.001.
5. Imamura Y, Engelbert M, Iida T, et al. Polypoidal choroidal vasculopathy: a review[J]. Surv Ophthalmol, 2010, 55(6): 501-515. DOI: 10.1016/j.survophthal.2010.03.004.
6. 徐晓莉, 张喜梅.眼底自发荧光技术在湿性年龄相关性黄斑变性诊断中的应用[J]. 国际眼科纵览, 2015, 39(1): 25-29. DOI: 10.3706/cma.j.issn.1673-5803.2015.01.005.Xu XL, Zhang XM. Application of fundus autofluorescence in diagnosis of wet age-related macular degeneration[J]. Int Rev Ophthalmol, 2015, 39(1): 25-29. DOI: 10.3706/cma.j.issn.1673-5803.2015.01.005.
7. Yamagishi T, Koizumi H, Yamazaki T, et al. Changes in fundus autofluorescence after treatments for polypoidal choroidal vasculopathy[J]. Br J Ophthalmol, 2014, 98(6): 780-784. DOI: 10.1136/bjophthalmol-2013-303739.
8. Suzuki M, Gomi F, Sawa M, et al. Changes in fundus autofuorescence in polypoidal choroidal vasculopathy during 3 years of follow-up[J]. Graefe's Arch Clin Exp Ophthalmol, 2013, 251(10): 2331-2337. DOI: 10.1007/s00417-013-2336-1.
9. Yamagishi T, Koizumi H, Yamazaki T, et al. Fundus autofuorescence in polypoidal choroidal vasculopathy[J]. Ophthalmology, 2012, 119(8): 1650-1657. DOI: 10.1016/j.ophtha.2012.02.016.
10. Ojima Y, Hangai M, Sakamoto A, et al. Improved visualization of polypoidal choroidal vasculopathy lesions using spectral-domain optical coherence tomography[J]. Retina, 2009, 29(1): 52-59. DOI: 10.1097/IAE.0b013e3181884fbf.
11. Sato T, Kishi S, Watanabe G, et al. Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy[J]. Retina, 2007, 27(5): 589-594. DOI: 10.1097/01.iae.0000249386.63482.05.
12. Holz FG, Bindewald-Wittich A, Fleckenstein M, et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration[J]. Am J Ophthalmol, 2007, 143(3): 463-472. DOI: 10.1016/j.ajo.2006.11.041.
13. Hikichi T, Higuchi M, Matsushita T, et al. One-year results of three monthly ranibizumab injections and as-needed reinjections for polypoidal choroidal vasculopathy in Japanese patients[J]. Am J Ophthalmol, 2012, 154(1): 117-124. DOI: 10.1016/j.ajo.2011.12.019.
14. Nakashizuka H, Mitsumata M, Okisaka S, et al. Clinicopathologic findings in polypoidal choroidal vasculopathy[J]. Invest Ophthalmol Vis Sci, 2008, 49(11): 4729-4737. DOI: 10.1167/iovs.08-2134.
15. Schmitz-Valckenberg S, Holz FG, Bird AC, et al. Fundus autofuorescence imaging: review and perspectives[J]. Retina, 2008, 28(3): 385-409. DOI: 10.1097/IAE.0b013e318164a907.
16. Akaza E, Yuzawa M, Mori R. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy[J]. Jpn J Ophthalmol, 2011, 55(1): 39-44. DOI: 10.1007/s10384-010-0886-x.
17. Saito M, Iida T, Kano M. Intravitreal ranibizumab for polypoidal choroidal vasculopathy with recurrent or residual exudation[J]. Retina, 2011, 31(8): 1589-1597. DOI: 10.1097/IAE.0b013e31820f4b21.

Chinese Journal of Ocular Fundus Diseases

Changes of fundus autofluorescence in polypoidal choroidal vasculopathy before and after intravitreal ranibizumab injections

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