Eye (Lond). 2026 Oct;40(14):2215-2220. doi: 10.1038/s41433-026-04697-6.
Summary
PCV New polyps develop in 33% of eyes (80% de novo) undergoing anti-VEGF treat-extend — Retrospective, 45 eyes
Abstract
Objectives: To evaluate the incidence of newly formed polypoidal lesions (PLs) and associated neovascular lesion changes in eyes with polypoidal choroidal vasculopathy (PCV) using optical coherence tomography angiography (OCTA).
Methods: The medical records of patients diagnosed with PCV who were treated with intravitreal anti-vascular endothelial growth factor therapy and followed up for at least 3 years were retrospectively reviewed. Patients were classified into a new PL group or no new PL group based on the development of new PLs on OCTA during the follow-up period. The primary outcome measures included the incidence of new PLs and changes in morphological characteristics (area and circularity) of the neovascular lesions.
Results: The final analysis included 45 eyes from 45 patients. New PLs were observed in 15 (33.3%) eyes. The new PL group demonstrated a significantly greater increase in neovascular lesion area compared with the no new PL group (1.63 ± 0.54 mm² vs. 0.19 ± 0.54 mm²; P = 0.041). Furthermore, the new PL group exhibited a significant decline in neovascular lesion circularity compared with the no new PL group (-0.052 ± 0.040 vs. 0.029 ± 0.030; P = 0.004). Most new PLs (80%) were classified as de novo, defined as those developing in a location where no neovascular lesions were present at the previous visit.
Conclusion: New PL formation frequently occurs in patients with PCV undergoing a treat-and-extend protocol. Expansion of the neovascular area and worsening of circularity have been identified as key precursors of new PL development.
