Present indications for removal of choroidal neovascular membranes

Current Opinion in Ophthalmology

Volumn 9, Issue 3, 1998, Pages 23-30

  Joseph, Daniel P ^a   Thomas, Matthew A ^a  

^a WASHINGTON UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

HUMAN; MEMBRANE; PIGMENT EPITHELIUM; PRIORITY JOURNAL; RECURRENCE RISK; REVIEW; SUBRETINAL NEOVASCULARIZATION; SURGICAL TECHNIQUE;

CHOROID; HUMANS; NEOVASCULARIZATION, PATHOLOGIC; OPHTHALMOLOGIC SURGICAL PROCEDURES; RECURRENCE; TIME FACTORS;

EID: 0031851079     PISSN: 10408738     EISSN: None     Source Type: Journal    
DOI: 10.1097/00055735-199806000-00005     Document Type: Review

References (44)

1. Gass JDM: Biomicroscopic and histopathologic considerations regarding the feasibility of surgical excision of subfoveal neovascular membranes. Am J Ophthalmol 1994, 118:285-298.
2. Thomas MA, Grand MG, Williams DF, Lee CM, Pesin SR, Lowe MA: Surgical management of subfoveal choroidal neovascularization. Ophthalmology 1992, 99:952-968.
3. Berger AS, Kaplan HJ: Clinical experience with the surgical removal of subfoveal neovascular membranes. Ophthalmology 1992, 99:969-976.
4. Melberg NS, Thomas MA, Burgess DB: The surgical removal of subfoveal choroidal neovascularization: ingrowth site as a predictor of visual outcome. Retina 1996, 16:190-195. A retrospective review of preoperative fluorescein angiograms in 84 eyes with subfoveal choroidal neovascular (CNV) membrane identified ingrowth sites in 67 eyes classified as being either extrafoveal, juxtafoveal, or subfoveal in location; 17 eyes had ingrowth sites that were not identifiable. The best visual acuities (VAs) postoperatively tended to be in patients with extrafoveal ingrowth sites. Subfoveal or unidentifiable ingrowth sites were associated with guarded visual prognoses.
5. Macular Photocoagulation Study Group: Laser photocoagulation of Juxtafoveal choroidal neovascularization. Arch Ophthalmol 1994, 112:500-509.
6. Macular Photocoagulation Study Group: The influence of treatment extent on the visual acuity of eyes treated with krypton laser for juxtafoveal choroidal neovascularization. Arch Opthalmol 1995, 113:190-194.
7. Macular Photocoagulation Study Group: Argon laser photocoagulation for neovascular maculopathy: five-year results from randomized clinical trials. Arch Opthalmol 1991, 109:1109-1114.
8. de Juan E, Machemer R: Vitreous surgery for hemorrhagic and fibrous complications of age-related macular degeneration. Am J Ophthalmol 1988, 105:25-29.
9. Blinder KJ, Peyman GA, Paris CL, Gremillion CM Jr: Submacular scar excision in age-related macular degeneration. Int Ophthalmol Clin 1991, 15:215-222.
10. Peyman GA, Blinder KJ, Paris CL, Alturki W, Nelson NC, Desai U: A technique for retinal pigment epithelium transplantation for age-related macular degeneration secondary to extensive subfoveal scarring. Ophthalmic Surg 1991, 22:102-108.
11. Thomas MA, Kaplan HJ: Surgical removal of subfoveal neovascularization in the presumed ocular histoplasmosis syndrome. Am J Ophthalmol 1991, 111:1-7.
12. Lambert HM, Capone A, Aaberg TM, Sternberg P Jr, Mandell BA, Lopez Pf: Surgical excision of subfoveal neovascular membranes in age-related macular degeneration. Am J Ophthalmol 1991, 113:257-262.
13. Ibanez HE, Thomas MA: Surgical approach to subfoveal neovascularizatjon and submacular hemorrhage. Seminars in Ophthalmol 1994, 9:56-64.
14. Thomas MA, Dickinson JD, Melberg NS, Ibanez HE, Dhaliwal RS: Visual results after surgical removal of subfoveal choroidal neovascular membranes. Ophthalmology 1994, 101:1384-1396.
15. Holekamp NM, Thomas MA, Dickinson JD, Valluri S: Surgical removal of subfoveal choroidal neovascularization in presumed ocular histoplasmosis: stability of early visual results. Ophthalmology 1997, 104:22-26. A retrospective study with median follow-up of 13 months for 117 patients who underwent surgery for subfoveal CNV membrane secondary to presumed ocular histoplasmosis syndrome. Thirty-five percent of patients had postoperative VA of 20/40 or better, and 40% had improvement of three or more lines of VA. This study confirms initial results which suggested a beneficial effect after surgical removal of subfoveal CNV in presumed ocular histoplasmosis syndrome.
16. Olsen TW, Capone A Jr, Sternberg P Jr, Grossniklaus He, Martin DF, Aaberg TM: Subfoveal choroidal neovascularization in punctate inner choroidopathy: surgical management and pathologic findings. Ophthalmology 1996, 103:2061-2069. Five patients (six eyes) with punctate inner choroidopathy underwent submacular surgery for subfoveal CNV. Visual improvement was noted postoperatively in all six eyes; recurrences occurred six times in four eyes and were managed surgically with laser or with observation. Histopathologic evaluation of excised tissues was performed. The authors propose a staging system for the development of CNV and subsequent subretinal fibrosis.
17. Adelberg DA, Del Priore LV, Kaplan HJ: Surgery for subfoveal membranes in myopia, angioid streaks, and other disorders. Retina 1995, 15:198-205.
18. Green WR, Enger C: Age-related macular degeneration histopathologic studies: The 1992 Lorenz E. Zimmerman lecture. Ophthalmology 1993, 100:1519-1535.
19. Ormerod LD, Puklin JE, Frank RN: Long-term outcomes after the surgical removal of advanced subfoveal neovascular membranes in age-related macular degeneration. Ophthalmology 1994, 101:1201-1210.
20. Sabates NR, Crane WG, Sabates FN, Schuchard RA, Fletcher DC: Scanning laser ophthalmoscope macular perimetry in the evaluation of submacular surgery. Retina 1996, 16:296-304. Scanning laser ophthalmoscope was used to test presurgical and postsurgical visual function in patients undergoing submacular surgery for subfoveal CNV secondary to age-related macular degeneration (AMD), presumed ocular histoplasmosis syndrome, and submacular hemorrhage secondary to AMD. Surgery led to decreased scotoma size and improvement in preferred retinal locus for fixation location; both corresponded with VA.
21. Rosa RH, Thomas MA, Green WR: Clinicopathologic correlation of submacular membranectomy with retention of good vision in a patient with age-related macular degeneration. Arch Ophthalmol 1996, 114:480-487. A case report of the clinical pathologic features of the eye of a patient who underwent surgery for a subfoveal CNV membrane secondary to AMD. The patient retained good vision for 4 years after surgery despite one recurrence, which was treated with laser photocoagulation.
22. Ibanez HE, Williams DF, Thomas MA, Ruby AJ, Meredith TA, Boniuk I, Grand MG: Surgical management of submacular hemorrhage: a series of 47 consecutive cases. Arch Ophthalmol 1995, 113:62-69.
23. Bennett SR, Folk JC, Blodi CF, Klugman M: Factors prognostic of visual outcome in patients with subretinal hemorrhage. Am J Ophthalmol 1990, 109:33-37.
24. Lewis H: Intraoperative fibrinolysis of submacular hemorrhage with tissue plasminogen activator and surgical drainage. Am J Ophthalmol 1994, 118:559-568.
25. Lim JI, Drews-Botsch C, Sternberg P Jr, Capone A, Aaberg TM: Submacular hemorrhage removal. Ophthalmology 1995, 102:1393-1399.
26. Kamei M, Tano Y, Maeno T, Ikuno Y, Mitsuda H, Yuasa T: Surgical removal of submacular hemorrhage using tissue plasminogen activator and perfluorocarbon liquid. Am J Ophthalmol 1996, 121:267-275.
27. Hochman MA, Seery CM, Zarbin MA: Pathophysiology and management of subretinal hemorrhage. Surv Ophthalmol 1997, 42:195-213. A comprehensive review of pathophysiology and management of subretinal hemorrhages. Guidelines for selecting candidates for surgical intervention for removal of subretinal hemorrhages are proposed. The value of surgically removing subretinal hemorrhages associated with AMD remains to be established.
28. Berrocal MH, Lewis ML, Flynn HW: Variations in the clinical course of submacular hemorrhage. Am J Ophthalmol 1996, 122:486-493.
29. Avery RL, Fekrat S, Hawkins BS, Bressler NM: Natural history of subfoveal hemorrhage in age-related macular degeneration. Retina 1996, 16:183-189.
30. Valluri S, Thomas MA, Melberg NS, Dickinson JD: Visual outcomes of surgery for subfoveal choroidal neovascular membranes (SFNVM) in multifocal choroiditis and other miscellaneous retinal disorders. Invest Ophthalmol Vis Sci 1996, 37(suppl):428.
31. Macular Photocoagulation Study Group: Laser photocoagulation of subfoveal neovascular lesions in age-related macular degeneration: results of a randomized clinical trial. Arch Ophthalmol 1991, 109:1220-1221.
32. Macular Photocoagulation Study Group: Laser photocoagulation of subfoveal recurrent neovascular lesions in age-related macular degeneration: results of a randomized clinical trial. Arch Ophthalmol 1991, 109:1232-1241.
33. Olk RJ, Burgess DB, McCormick PA: Subfoveal and juxtafoveal subretinal neovascularization in the presumed ocular histoplasmosis syndrome: visual prognosis. Ophthalmology 1994, 91:1592-1602.
34. Ho AC, Yannuzzi LA, Pisicano K, DeRosa J: The natural history of idiopathic subfoveal choroidal neovascularization. Ophthalmology 1995, 102:782-789.
35. Macular Photocoagulation Study Group: Krypton laser photocoagulation for idiopathic neovascular lesions: results of a randomized clinical trial. Arch Ophthalmol 1990, 108:323-837.
36. Macular Photocoagulation Study Group: Laser photocoagulation for neovascular lesions nasal to the fovea: results from clinical trials for lesions secondary to ocular hlstoplasmosis or idiopathic causes. Arch Ophthalmol 1995, 113:56-61.
37. Atebara NH, Thomas MA, Melberg NS, Mandell BA, Del Priore LV: Surgical removal of large non-AMD peripapillary choroidal neovascular membranes. Ophthalmology 1998, in press. Large peripapillary CNV membranes secondary to presumed ocular histoplasmosis syndrome and anomalous disc that would not qualify for the Macular Photocoagulation Study criteria were treated surgically. Eighteen of 19 patients experienced either improvement or stabilization of vision, with 79% of patients improving three or more lines of Snellen's VA. The results are very encouraging for surgical excision of large peripapillary membranes.
38. Joseph DP, MA Thomas: Surgical treatment of juxtafoveal choroidal neovascularization. Invest Ophthalmol Vis Res 1997, 38(suppl):457.
39. Macular Photocoagulation Study Group: Krypton laser photocoagulation for neovascular lesions of ocular histoplasmosis: results of a randomized clinical trial. Arch Ophthalmol 1987, 105:1499-1507.
40. Connor TB, Wolf MD, Arrindell EL, Mieler WF: Surgical removal of an extrafoveal fibrotic choroidal neovascular membrane with foveal serous detachment in age-related macular degeneration. Retina 1994, 14:125-129.
41. Melberg NS, Thomas MA, Dickinson JD, Valluri S: Managing recurrent neovascularization after subfoveal surgery in presumed ocular histoplasmosis syndrome. Ophthalmology 1996, 103:1064-1068. Recurrent neovascularization developed in 51 eyes (44%) of 117 patients with presumed ocular histoplasmosis syndrome who underwent surgery for subfoveal CNV. Recurrence location was extrafoveal in 16%, juxtafoveal in 18%, and subfoveal in 66%. The best visual outcomes were obtained in patients who underwent laser for recurrences extrafoveal in location. Patients who had subfoveal recurrences experienced similar visual outcomes with surgery or observation.
42. Tezel TH, Del Priore LV, Flowers BE, Grosof DH, Benenson IL, Zamora RL, Kaplan HJ: Correlation between scanning laser ophthalmoscope microperimetry and anatomic abnormalities in patients with subfoveal neovascularization. Ophthalmology 1996, 103:1829-1836. The results of scanning laser ophthalmoscope microperimetry were superimposed on color fundus photographs and fluorescein angiograms of 21 eyes with subfoveal neovascular membranes. Absolute scotomas were most likely to be associated with chorioretinal scars or retinal pigment epithelial atrophy. Subretinal hemorrhage and subretinal membranes were sometimes associated with absolute scotomas.
43. Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL: Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 1984, 91:1573-1581.
44. Thomas MA: Surgical removal of subfoveal choroidal neovascular membranes. In Retina, edn. 2. St. Louis: Mosby Year book; 1994:2385-2393.