Seo Hee Kim MD , Kai Tzu-iunn Ong , Seonghee Choi MD , Eun Jee Chung MD, PhD , Min Kim MD, PhD , Christopher Seungkyu Lee MD, PhD , Jinyoung Yeo PhD , Eun Young Choi MD, PhD
{"title":"年龄相关的分散低荧光斑是息肉样脉络膜血管病变的不良预后因素","authors":"Seo Hee Kim MD , Kai Tzu-iunn Ong , Seonghee Choi MD , Eun Jee Chung MD, PhD , Min Kim MD, PhD , Christopher Seungkyu Lee MD, PhD , Jinyoung Yeo PhD , Eun Young Choi MD, PhD","doi":"10.1016/j.xops.2025.100818","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Polypoidal choroidal vasculopathy (PCV) demonstrates significant prognostic variability, and the impact of age-related scattered hypofluorescent spots observed in late-phase indocyanine green angiography (ASHS-LIA) on the prognosis of PCV remains under-researched. This study aims to investigate the association between ASHS-LIA in PCV and prognosis using the AdaBoost machine learning model.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Participants</h3><div>The study included patients diagnosed with PCV and treated with anti-VEGF therapy at 2 medical institutions between 2012 and 2021.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of the clinical characteristics, anti-VEGF treatment history, and outcomes of the participants, classifying them based on the presence or absence of ASHS-LIA. An AdaBoost meta-estimator was applied to predict prognosis, including disease stability, injection frequency, and time to first remission, utilizing features selected through principal component analysis.</div></div><div><h3>Main Outcome Measures</h3><div>The prognostic significance of ASHS-LIA was assessed by feature importance, with the mean decrease in impurity serving as the evaluation metric.</div></div><div><h3>Results</h3><div>Of 57 eyes with PCV, 31 exhibited ASHS-LIA and 26 did not. Compared with the non-ASHS-LIA group, the ASHS-LIA group had fewer patients who achieved a super-stable status without recurrence for >18 months postremission (<em>P =</em> 0.03), required a longer time to reach first remission (<em>P</em> = 0.04), and needed more injections (<em>P</em> < 0.001). AdaBoost models confirmed the importance of ASHS-LIA for predicting disease stability, injection demand, and time to first remission, ranking it as the third, seventh, and eighth top contributory factor, respectively.</div></div><div><h3>Conclusions</h3><div>Machine learning analysis identified ASHS-LIA as a negative prognostic factor in PCV, correlating with reduced disease stability, higher recurrence rates, and increased treatment requirements. These findings suggest that ASHS-LIA could serve as a valuable marker for assessing prognosis and guiding treatment strategies in PCV management.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 5","pages":"Article 100818"},"PeriodicalIF":3.2000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Age-Related Scattered Hypofluorescent Spots as an Adverse Prognostic Factor for Polypoidal Choroidal Vasculopathy\",\"authors\":\"Seo Hee Kim MD , Kai Tzu-iunn Ong , Seonghee Choi MD , Eun Jee Chung MD, PhD , Min Kim MD, PhD , Christopher Seungkyu Lee MD, PhD , Jinyoung Yeo PhD , Eun Young Choi MD, PhD\",\"doi\":\"10.1016/j.xops.2025.100818\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>Polypoidal choroidal vasculopathy (PCV) demonstrates significant prognostic variability, and the impact of age-related scattered hypofluorescent spots observed in late-phase indocyanine green angiography (ASHS-LIA) on the prognosis of PCV remains under-researched. This study aims to investigate the association between ASHS-LIA in PCV and prognosis using the AdaBoost machine learning model.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Participants</h3><div>The study included patients diagnosed with PCV and treated with anti-VEGF therapy at 2 medical institutions between 2012 and 2021.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of the clinical characteristics, anti-VEGF treatment history, and outcomes of the participants, classifying them based on the presence or absence of ASHS-LIA. An AdaBoost meta-estimator was applied to predict prognosis, including disease stability, injection frequency, and time to first remission, utilizing features selected through principal component analysis.</div></div><div><h3>Main Outcome Measures</h3><div>The prognostic significance of ASHS-LIA was assessed by feature importance, with the mean decrease in impurity serving as the evaluation metric.</div></div><div><h3>Results</h3><div>Of 57 eyes with PCV, 31 exhibited ASHS-LIA and 26 did not. Compared with the non-ASHS-LIA group, the ASHS-LIA group had fewer patients who achieved a super-stable status without recurrence for >18 months postremission (<em>P =</em> 0.03), required a longer time to reach first remission (<em>P</em> = 0.04), and needed more injections (<em>P</em> < 0.001). AdaBoost models confirmed the importance of ASHS-LIA for predicting disease stability, injection demand, and time to first remission, ranking it as the third, seventh, and eighth top contributory factor, respectively.</div></div><div><h3>Conclusions</h3><div>Machine learning analysis identified ASHS-LIA as a negative prognostic factor in PCV, correlating with reduced disease stability, higher recurrence rates, and increased treatment requirements. These findings suggest that ASHS-LIA could serve as a valuable marker for assessing prognosis and guiding treatment strategies in PCV management.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>\",\"PeriodicalId\":74363,\"journal\":{\"name\":\"Ophthalmology science\",\"volume\":\"5 5\",\"pages\":\"Article 100818\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-05-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666914525001162\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666914525001162","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Age-Related Scattered Hypofluorescent Spots as an Adverse Prognostic Factor for Polypoidal Choroidal Vasculopathy
Purpose
Polypoidal choroidal vasculopathy (PCV) demonstrates significant prognostic variability, and the impact of age-related scattered hypofluorescent spots observed in late-phase indocyanine green angiography (ASHS-LIA) on the prognosis of PCV remains under-researched. This study aims to investigate the association between ASHS-LIA in PCV and prognosis using the AdaBoost machine learning model.
Design
A cross-sectional study.
Participants
The study included patients diagnosed with PCV and treated with anti-VEGF therapy at 2 medical institutions between 2012 and 2021.
Methods
We conducted a retrospective analysis of the clinical characteristics, anti-VEGF treatment history, and outcomes of the participants, classifying them based on the presence or absence of ASHS-LIA. An AdaBoost meta-estimator was applied to predict prognosis, including disease stability, injection frequency, and time to first remission, utilizing features selected through principal component analysis.
Main Outcome Measures
The prognostic significance of ASHS-LIA was assessed by feature importance, with the mean decrease in impurity serving as the evaluation metric.
Results
Of 57 eyes with PCV, 31 exhibited ASHS-LIA and 26 did not. Compared with the non-ASHS-LIA group, the ASHS-LIA group had fewer patients who achieved a super-stable status without recurrence for >18 months postremission (P = 0.03), required a longer time to reach first remission (P = 0.04), and needed more injections (P < 0.001). AdaBoost models confirmed the importance of ASHS-LIA for predicting disease stability, injection demand, and time to first remission, ranking it as the third, seventh, and eighth top contributory factor, respectively.
Conclusions
Machine learning analysis identified ASHS-LIA as a negative prognostic factor in PCV, correlating with reduced disease stability, higher recurrence rates, and increased treatment requirements. These findings suggest that ASHS-LIA could serve as a valuable marker for assessing prognosis and guiding treatment strategies in PCV management.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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