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Surgical Treatment of Peripapillary Choroidal Neovascularization
  1. Sabine Aisenbrey (s.aisenbrey{at}web.de),
  2. Faik Gelisken (faikgelisken{at}med.uni-tuebingen.de),
  3. Peter Szurman (peter.szurman{at}med.uni-tuebingen.de),
  4. Ulrich K Bartz-Schmidt (u.bartzschmidt{at}googlemail.com)
  1. University of Tuebigen, Department of Ophthalmology, Germany
  2. University of Tuebigen, Department of Ophthalmology, Germany
  3. University of Tuebigen, Department of Ophthalmology, Germany
  4. University of Tuebigen, Department of Ophthalmology, Germany

    Abstract

    Purpose: To report functional and morphological outcome of surgical treatment of peripapillary choroidal neovascularization due to age-related macular degeneration.

    Methods: Consecutive interventional case series of eight patients with extensive peripapillary choroidal neovascularization and accompanying haemorrhage who underwent subretinal surgery including extraction of neovascular complex. Ophthalmic examination including visual acuity testing, colour photography, and fluorescein angiography were performed at baseline and at three, six, nine, 12 months, and then yearly.

    Results: Mean follow-up was 26 months (12 to 60 months). Preoperative best-corrected visual acuity ranged from logMAR 1.0 (20/200) to logMAR 0.0 (20/20) with a mean of logMAR 0.5 (20/63). Mean postoperative BCVA was logMAR 0.3 (20/40). BCVA improved in six patients, was stable in one patient and deteriorated in one patient. Two years after surgery one patient developed recurrence of the CNV that was removed surgically. One patient showed retinal detachment five years after subretinal surgery.

    Conclusions: In this small case series of PPCNV functional improvement was achieved after surgery in the majority of patients. Surgical extraction of the CNV represents an alternative treatment option in eyes with vision threatening extensive peripapillary choroidal neovascularization. Randomized controlled studies seem to be justified to further evaluate beneficial effect long-term functional outcome of this therapy approach.

    • age-related macular degeneration
    • choroidal neovascularization
    • peripapillary
    • subretinal surgery

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