Distinguishing Polypoidal Choroidal Vasculopathy From Typical Neovascular Age-Related Macular Degeneration Based on Spectral Domain Optical Coherence Tomography

In Brief Purpose: To investigate the sensitivity and specificity of spectral domain optical coherence tomography in distinguishing polypoidal choroidal vasculopathy (PCV) from typical neovascular age-related macular degeneration (nAMD). Methods: One hundred and eighty-eight eyes in 156 patients with active PCV or typical nAMD were enrolled prospectively. Three spectral domain optical coherence tomography manifestations, pigment epithelium detachment, double-layer sign, and thumb-like polyps were estimated in all the eyes. A diagnostic test to differentiate PCV from nAMD based on spectral domain optical coherence tomography was performed. Furthermore, the sensitivity and specificity was validated in a retrospective series of patients. Results: Pigment epithelium detachment, double-layer sign, and thumb-like polyps were more common in PCV eyes than in nAMD eyes. When the cutoff point was set as at least 2 positive signs out of 3 in the diagnostic test, the sensitivity was 89.4% and specificity was 85.3%. The results of the validation test further confirmed the strategy, with satisfying sensitivity (87.5%) and specificity (86.2%). Conclusion: Spectral domain optical coherence tomography is sensitive and specific in distinguishing PCV from nAMD. From these results, the presence of at least two out three signs (pigment epithelium detachment, double-layer sign, and thumb-like polyps) indicates a positive test and is therefore suggested to be the screening strategy for PCV. Three SD-OCT signs, namely pigment epithelium detachment, double-layer sign, and thumb-like polyps, were more common in polypoidal choroidal vasculopathy than in typical neovascular age-related macular degeneration. A sensitivity and specificity was calculated to distinguish polypoidal choroidal vasculopathy from neovascular age-related macular degeneration based on SD-OCT. The results suggested that the presence of at least two of the three signs could be considered as the screening strategy for polypoidal choroidal vasculopathy.