Background: To determine the role played by vascular endothelial growth factor (VEGF) in polypoidal choroidal\r\nvasculopathy (PCV) based on an interventional immunology theory.\r\nMethods: Eyes with PCV were divided in a masked fashion into those with choroidal hyperpermeability (HP group)\r\nand those with normal choroidal permeability (NP group) based on the indocyanine green angiograms. The inter-rater\r\nagreement rate was evaluated using Fleissââ?¬â?¢ kappa. Patients were treated by intravitreal ranibizumab (IVB). The central\r\nchoroidal thickness and central foveal thickness (CFT) at the baseline and 7 days after the treatment were measured by\r\noptical coherence tomography.\r\nResults: Among the 57 consecutive eyes diagnosed with PCV, 42 eyes of 42 patients met the inclusion criteria\r\n(21 eyes/HP group vs 21 eyes /NP group). Central choroidal thickness in HP group was significantly thicker than that in\r\nthe NP group (P < .001, Mannââ?¬â??Whitney U test). The inter-rater agreement was high with a Fleissââ?¬â?¢ kappa = 0.95, P < .0001.\r\nThe percentage reduction in the CFT in HP group (14.0%) was significantly less than that in NP group (20.4%; P = .013,\r\nMannââ?¬â??Whitney U test).\r\nConclusions: Eyes with PCV that are associated with choroidal hyper-permeability may not be strongly associated with\r\nVEGF-related pathology, and may not respond favorably to anti-VEGF monotherapy
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