Differences between young and elderly polypoidal choroidal vasculopathy patients with and without pachychoroid phenotypes

期刊论文
发表日期：

2024年1月17日

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Yuelin Wang,
Wenfei Zhang,
Jingyuan Yang,
Xinyu Zhao,
Lihui Meng,
Youxin Chen,
Xiao Zhang,
Huiqin Lu,
Bojun Zhao,
Yanping Song,
Haifeng Xu,
Wei Xia,
Xiaoyan Ding,
Yi Qu,
Zhiqing Li,
Yunxian Gao,
Suqin Yu,
Xiaoling Liu,
Yun Xiao,
Yibin Li,
Haiying Zhou,
Gongqiang Yuan,
Hong Zhang,
Yanyun Shi,
Qingshan Chen,
Wenfang Zhang,
Jun Xiao,
Wei Gu,
Wei Zhou,
Tianhua Piao,
Dawei Sun,
Tien Yin Wong

摘要

Purpose

To investigate the distinct characteristics between young and elderly polypoidal choroidal vasculopathy (PCV) patients based on the pachy- or non-pachychoroid phenotypes.

Methods

PCV patients treated with intravitreal injections of Conbercept based on the 3 + PRN regimen from 27 centers of China PCV Research Alliance were included. Patients were categorized into the young and the elderly aged group based on the cut-off point determined using the Youden method according to the pachychoroid phenotypes. The characteristics of past medical history, lifestyle factors, fundus manifestations, and treatment response between the subgroups were analyzed.

Results

Three hundred eight eligible patients were included. Multivariate logistic regression showed a significant association between age and PCV subtype classification (OR = 0.921, P = 0.002). A cutoff age of 64.5 effectively distinguished between pachychoroid PCV and non-pachychoroid PCV (P < 0.001). Elderly PCV patients had a higher incidence of hypertension history (P = 0.044) but a lower incidence of diabetes history (P = 0.027). In terms of lifestyle, smoking history (P = 0.015) and staying up late (P = 0.004) were more significant in the young group of PCV patients. For clinical characteristics, the proportion of hemorrhagic PCV in the young group was significantly higher (P = 0.038), with a higher proportion of sharp-peaked PED (P = 0.049), thicker choroid (P < 0.001) but a lower portion of double-layer sign (P = 0.023) in OCT. Both groups showed significant anatomical changes compared to baseline in each follow-up period (P < 0.05), with the young group having a higher proportion of good anatomical response after the first injection (P = 0.009).

Conclusion

PCV patients stratified by subtype exhibit distinct characteristics between the young and elderly groups.