Clinical Relevance of Aqueous Vascular Endothelial Growth Factor Levels in Polypoidal Choroidal Vasculopathy

In Brief Purpose: To investigate vascular endothelial growth factor (VEGF) level according to the clinical and imaging features, and to explore its relationship with the responsiveness to anti-VEGF treatment in eyes with polypoidal choroidal vasculopathy. Methods: Aqueous samples were collected from 62 eyes of 62 patients with treatment-naïve polypoidal choroidal vasculopathy. Vascular endothelial growth factor levels were measured using enzyme-linked immunosorbent assay. Baseline best-corrected visual acuity, central macular thickness, subfoveal choroidal thickness, greatest linear dimension of the lesion, and the presence of hemorrhage were included in the analysis. The effects of 3 monthly intravitreal ranibizumab injections on best-corrected visual acuity and central macular thickness were assessed. Results: Baseline VEGF level was negatively correlated with subfoveal choroidal thickness (r = −0.33, P = 0.01). Other variables had no correlation with VEGF level. The mean change in central macular thickness after anti-VEGF treatment was −51 ± 64 μm, which is positively correlated with VEGF concentration (r = 0.30, P = 0.04) and negatively correlated with subfoveal choroidal thickness (r = −0.35, P = 0.02). Conclusion: Vascular endothelial growth factor level demonstrated a negative correlation with baseline subfoveal choroidal thickness and was associated with response to anti-VEGF treatment. These findings suggest that VEGF has a variable contribution to the pathogenesis of polypoidal choroidal vasculopathy depending on choroid thickness. Polypoidal choroidal vasculopathy has distinctive features compared with neovascular age-related macular degeneration, including lower response to anti–vascular endothelial growth factor treatment and thicker choroid. In this study, the authors analyzed vascular endothelial growth factor levels in eyes affected by polypoidal choroidal vasculopathy and evaluated their correlation with clinical factors, focusing on choroidal thickness and response to anti–vascular endothelial growth factor treatment.