Original ArticleChorioretinal damage caused by the excision of choroidal neovascularization
Section snippets
Patients and methods
We studied 18 eyes of 18 consecutive patients who underwent choroidal neovascularization excision at Osaka University Hospital from June 1994 to September 1995. All patients met the following eligibility criteria: (1) evident and well-demarcated choroidal neovascularization by slit-lamp fundus biomicroscopy, fluorescein angiography, and/or indocyanine green angiography; (2) choroidal neovascularization extending under the center of the fovea (subfoveal type choroidal neovascularization) or to
Results
The group of patients studied included 13 men and five women. Their average age was 61.2 ± 13.9 (mean ± SD) years (range, 27 to 78 years). The cause of choroidal neovascularization was age-related macular degeneration in 14 cases and was idiopathic in four cases. The choroidal neovascularization was subfoveal in 13 cases and juxtafoveal in five cases. Table 1shows baseline patient characteristics. The mean follow-up was 20.1 ± 6.8 months. The preoperative mean logMAR visual acuity was 1.04 ±
Discussion
In patients with choroidal neovascularization of various causes, especially as a result of age-related macular degeneration, primary retinal pigment epithelium dysfunction and an associated choriocapillaris circulation defect are present, which may lead to damage to the overlying retina.9 Therefore, damage of the retina in the area that corresponds to excised choroidal neovascularization may have been present preoperatively. To evaluate the mechanical damage caused by surgery, we chose to study
References (12)
- et al.
Visual results after surgical removal of subfoveal choroidal neovascular membranes
Ophthalmology
(1994) Biomicroscopic and histopathologic considerations regarding the feasibility of surgical excision of subfoveal neovascular membranes
Am J Ophthalmol
(1994)- et al.
Long-term outcomes after the surgical removal of advanced subfoveal neovascular membranes in age-related macular degeneration
Ophthalmology
(1994) - et al.
Macular sparing as a perimetric artifact
Am J Ophthalmol
(1995) - et al.
Retinal pigment epithelial debridement as a model for the pathogenesis and treatment of macular degeneration
Am J Ophthalmol
(1996) - et al.
Retinal cell transplantation in the macular
Vision Res
(1996)
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2023, Survey of OphthalmologyRetinal pigment epithelial cell transplantation after subfoveal membranectomy in age-related macular degeneration: Clinicopathologic correlation
2001, American Journal of OphthalmologyCitation Excerpt :There is incomplete resurfacing of the retinal pigment epithelium defect after surgical excision of a choroidal neovascular membrane in age-related macular degeneration,22,23 and damage to or removal of the retinal pigment epithelium leads to choriocapillaris atrophy in animal models.38–45 Although choroidal neovascular membrane excision can cause mechanical damage to the outer retina and choriocapillaris,46 removal of the native retinal pigment epithelium during submacular surgery may lead to secondary atrophy of the subfoveal choriocapillaris in some eyes, if it has not already occurred.36 Retinal pigment epithelium transplantation may prevent or reverse postoperative atrophy of the subfoveal choriocapillaris and improve the visual prognosis in this disease.36
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