EFFECTS OF VITREOMACULAR ADHESION ON ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT FOR POLYPOIDAL CHOROIDAL VASCULOPATHY

Purpose: To evaluate the effect of posterior vitreomacular adhesion (VMA), documented by optical coherence tomography, on the outcome of anti-vascular endothelial growth factor treatment of polypoidal choroidal vasculopathy. Methods: Medical records of 102 patients (104 eyes) with polypoidal choroidal vasculopathy were retrospectively reviewed and categorized according to the presence of posterior VMA into 2 subgroups: VMA positive (+) group (23 eyes) and VMA negative (-) group (81 eyes). Best-corrected visual acuity and central macular thickness after anti-vascular endothelial growth factor treatment were compared between the 2 groups at baseline and at 1 month, 3 months, 6 months, and 12 months. Results: At the last follow-up, average number of injections was 4.82 +/- 1.27 in the VMA (+) group and 4.92 +/- 1.45 in the VMA (-) group. After injection, the mean logarithm of the minimum angle of resolution of best-corrected visual acuity improved from 0.81 +/- 0.53 (Snellen equivalent, 20/129) to 0.67 +/- 0.52 (Snellen equivalent, 20/93) in the VMA (+) group (P = 0.01) and from 0.79 +/- 0.50 (Snellen equivalent, 20/123) to 0.64 +/- 0.58 (Snellen equivalent, 20/91) in the VMA (-) group (P = 0.02). Average central macular thickness decreased from 354.4 +/- 124.5 mu m to 249.6 +/- 112.5 mm in the VMA (+) group (P = 0.01) and from 361.2 +/- 140.2 mu m to 267.3 +/- 103.5 mu m in the VMA (-) group (P = 0.01). Polyp regression rate was 21.7% (5 eyes of 23 eyes) in the VMA (+) group and 22.2% (18 eyes of 81 eyes) in the VMA (-) group. There was no statistically significant difference in the best-corrected visual acuity improvement, central macular thickness improvement, and polyp regression rate between the groups. Conclusion: Unlike typical age-related macular degeneration, posterior VMA was not associated with a visual outcome after intravitreal antivascular endothelial growth factor for polypoidal choroidal vasculopathy.