Long-term visual and anatomic outcomes of patients with peripapillary pachychoroid syndrome.


Journal

The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041

Informations de publication

Date de publication:
04 2022
Historique:
received: 22 09 2020
revised: 26 11 2020
accepted: 29 11 2020
pubmed: 24 12 2020
medline: 3 5 2022
entrez: 23 12 2020
Statut: ppublish

Résumé

To analyse the long-term anatomic and visual outcomes of patients with peripapillary pachychoroid syndrome (PPS), a recently described entity in the pachychoroid disease spectrum. This study retrospectively included patients from several retina centres worldwide. Visual acuity (VA), retinal thickness and choroidal thickness at baseline, 6 months and final follow-up were assessed. Temporal trends in VA and anatomic characteristics were evaluated. Visual and anatomic outcomes in eyes that were observed versus those that were treated were analysed. Fifty-six eyes of 35 patients were included with mean follow-up of 27±17 months. Median VA was 20/36 at baseline and remained stable through follow-up (p=0.77). Retinal thickness significantly decreased subfoveally (p=0.012), 1.5 mm nasal to the fovea (p=0.002) and 3.0 mm nasal to the fovea (p=0.0035) corresponding to areas of increased thickening at baseline. Choroidal thickness significantly decreased subfoveally (p=0.0030) and 1.5 mm nasal to the fovea (p=0.0030). Forty-three eyes were treated with modalities including antivascular endothelial growth factor injection, photodynamic therapy, and others. VA remained stable in treated eyes over follow-up (p=0.67). An isolated peripapillary fluid pocket in the outer nuclear layer was characteristic of PPS. Patients with PPS experienced decreased retinal oedema and decreased choroidal thickening throughout the course of disease. While some patients experienced visual decline, the overall visual outcome was relatively favourable and independent of trends in retinal or choroidal thickening.

Sections du résumé

BACKGROUND/AIMS
To analyse the long-term anatomic and visual outcomes of patients with peripapillary pachychoroid syndrome (PPS), a recently described entity in the pachychoroid disease spectrum.
METHODS
This study retrospectively included patients from several retina centres worldwide. Visual acuity (VA), retinal thickness and choroidal thickness at baseline, 6 months and final follow-up were assessed. Temporal trends in VA and anatomic characteristics were evaluated. Visual and anatomic outcomes in eyes that were observed versus those that were treated were analysed.
RESULTS
Fifty-six eyes of 35 patients were included with mean follow-up of 27±17 months. Median VA was 20/36 at baseline and remained stable through follow-up (p=0.77). Retinal thickness significantly decreased subfoveally (p=0.012), 1.5 mm nasal to the fovea (p=0.002) and 3.0 mm nasal to the fovea (p=0.0035) corresponding to areas of increased thickening at baseline. Choroidal thickness significantly decreased subfoveally (p=0.0030) and 1.5 mm nasal to the fovea (p=0.0030). Forty-three eyes were treated with modalities including antivascular endothelial growth factor injection, photodynamic therapy, and others. VA remained stable in treated eyes over follow-up (p=0.67). An isolated peripapillary fluid pocket in the outer nuclear layer was characteristic of PPS.
CONCLUSION
Patients with PPS experienced decreased retinal oedema and decreased choroidal thickening throughout the course of disease. While some patients experienced visual decline, the overall visual outcome was relatively favourable and independent of trends in retinal or choroidal thickening.

Identifiants

pubmed: 33355149
pii: bjophthalmol-2019-315550
doi: 10.1136/bjophthalmol-2019-315550
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

576-581

Informations de copyright

© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: NP: speaker for Allergan, Bayer, Novartis and Optovue. SL: consultant for Novartis, personal fees and non-financial support from Heidelberg Engineering and Carl Zeiss Meditec, personal fees from Novartis, Allergan and Bayer. WKL: consultant for Bayer Healthcare, Novartis, and Santen Pharmaceutical. SS: consultant for Heidelberg Engineering, Zeiss Meditec, Optovue, Optos, Centervue, Nidek, Novartis, Bayer. KBF: consultant for Zeiss, Optovue, Novartis, Allergan, and Heidelberg Engineering. DS: Consultant for Amgen, Bayer, Genentech, Heidelberg, Novartis, Optovue, Topcon, Regeneron.

Auteurs

David Xu (D)

Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA davidxu64@gmail.com.

Elisha Garg (E)

Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.

Kook Lee (K)

Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Yoichi Sakurada (Y)

Department of Ophthalmology, University of Yamanashi, Chuo, Yamanashi, Japan.

Atchara Amphornphruet (A)

Department of Ophthalmology, Rajavithi Hospital, Rangsit University, Bangkok, Thailand.

Nopasak Phasukkijwatana (N)

Department of Ophthalmology, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.

Sandra Liakopoulos (S)

Department of Ophthalmology, University of Cologne, Cologne, Germany.

Scott Eugene Pautler (SE)

Retina Vitreous Associates of Florida, Tampa, Florida, USA.

Allan E Kreiger (AE)

Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.

Suzanne Yzer (S)

Department of Ophthalmology, Rotterdam Eye Hospital, Rotterdam, The Netherlands.

Won Ki Lee (WK)

Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

SriniVas Sadda (S)

Retina Division, University of California-Los Angeles, Los Angeles, California, USA.

K Bailey Freund (KB)

Vitreous Retina Macula Consultants of New York, New York City, New York, USA.

David Sarraf (D)

Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.

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Classifications MeSH