Risk of Exudation in Eyes with Non-exudative Polypoidal Choroidal Vasculopathy

ABSTRACT Purpose: To investigate the characteristics and natural history of treatment-naïve non-exudative polypoidal choroidal vasculopathy (PCV) and to determine biomarkers predicting exudative conversion. Methods: Patients diagnosed with non-exudative PCV based on indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were included. Incidence of exudative conversion in non-exudative PCV patients and cumulative estimates for overall risk were assessed. ICGA and OCT imaging-based features were analyzed to identify risk factors for exudative conversion. Results: The study included 42 eyes of 40 patients with non-exudative PCV. The mean follow-up duration was 54.3 ± 35.5 months. Of the 42 eyes with non-exudative PCV, exudative conversion developed in 23 eyes (54.8%) after 42.2 ± 28.3 months (range, 8–103 months). Kaplan–Meier analysis showed that the exudation-free survival at 5 years after baseline was estimated to be 53.6%. Multivariate regression analysis showed that sequentially increased protrusion of retinal pigment epithelium in the polyp area was a significant risk factor for exudation in non-exudative PCV (odds ratio = 10.16, 95% CI:1.78 to 57.81, P = .01). Conclusions: Exudative conversion has been noted in nearly half of the non-exudative PCV cases in 5 years. The progressive protrusion of polypoidal lesions on OCT examination might be a significant biomarker for predicting the near-term onset of exudation.