Supplementary Material for: Exploring the ability of novel choroidal biomarkers in predicting treatment outcomes of polypoidal choroidal vasculopathy

Introduction: To explore the relationship between choroidal biomarkers and the response to anti- VEGF in PCV eyes.
Methods: A hospital-based retrospective study. We included 54 patients diagnosed with PCV who had received standard 3-monthly anti-VEGF monotherapy and had finished regular follow-ups. Choroidal thickness (CT), three-dimensional choroidal vascularity index (CVI), and the vascular density of choriocapillaris (CCVD) were measured utilizing SS-OCTA. Effective and poor responders were classified based on the changes of morphologic features. Multivariate linear regression models were performed for the outcomes to determine independent prognostic factors. Receiver operating characteristic (ROC) curves were used to compare the predictive ability of CT and CVI as biomarkers between effective and poor responders.
Results: A higher CVI at baseline was the only factor that correlated with the poor response after 3-monthly injections of anti-VEGF (P=0.038). The greater change of central macular thickness (CMT) was significantly correlated with increased CMT (P=0.030), decreased CT (P=0.042) and decreased CVI (p=0.038) at baseline. Using ROC curves, we found that the CVI value demonstrated superior predictive ability compared to the CT value, with AUC of 0.842 and the best cut-off value of 0.445.
Conclusion: A higher three-dimensional CVI using SS-OCTA is a promising biomarker to predict the poor anatomical response to anti-VEGF treatment in PCV patients.

Introduction: 本研究旨在探讨息肉状脉络膜血管病变（Polypoidal Choroidal Vasculopathy, PCV）患者眼部脉络膜生物标志物与抗血管内皮生长因子（anti-VEGF）治疗应答之间的关联。
Methods: 本研究为一项基于医院的回顾性研究，纳入54例确诊为PCV的患者，所有患者均接受标准的每3个月一次的抗VEGF单药治疗，并完成了规律随访。采用扫频源光学相干断层扫描血管成像（Swept-Source Optical Coherence Tomography Angiography, SS-OCTA）检测脉络膜厚度（Choroidal thickness, CT）、三维脉络膜血管指数（three-dimensional choroidal vascularity index, CVI）及脉络膜毛细血管血管密度（choriocapillaris vascular density, CCVD）。依据形态学特征变化将患者分为应答良好组与应答不良组。针对结局指标构建多元线性回归模型，以明确独立预后因素。采用受试者工作特征（Receiver Operating Characteristic, ROC）曲线比较CT与CVI作为生物标志物区分应答良好与不良组的预测效能。
Results: 基线时较高的CVI是唯一与抗VEGF每3个月注射治疗后不良应答相关的因素（P=0.038）。中心黄斑厚度（Central Macular Thickness, CMT）的变化幅度与基线时CMT升高（P=0.030）、CT降低（P=0.042）及CVI降低（P=0.038）显著相关。经ROC曲线分析发现，相较于CT，CVI具有更优的预测效能，其曲线下面积（Area Under Curve, AUC）为0.842，最佳截断值为0.445。
Conclusion: 采用SS-OCTA检测得到的较高三维CVI可作为预测PCV患者抗VEGF治疗后不良解剖应答的潜在生物标志物。