Br J Ophthalmol 1997;81:481-489 ( June )
Decreased choriocapillaris perfusion following surgical excision
of choroidal neovascular membranes in age-related macular degeneration
Ma'an A Nasir,b
Ilene Sugino,a
Marco A Zarbina
a Department of Ophthalmology, New Jersey Medical School,
University of Medicine and Dentistry of New Jersey, b Department of Ophthalmology, Duke
University Eye Center
Correspondence to: Marco A Zarbin, MD,
University of Medicine and Dentistry, New Jersey Medical School,
Department of Ophthalmology, 90 Bergen Street, DOC 6th floor, Newark,
NJ 07103-2499, USA.
Accepted for publication 10
March 1997
AIMS/BACKGROUND To evaluate macular changes
following surgical excision of subfoveal choroidal neovascular
membranes (CNVs) in age-related macular degeneration (AMD).
METHODSThe clinical records, fluorescein
angiograms, and CNV histopathology of 12 patients with AMD who
underwent surgical excision of subfoveal CNV were reviewed.
RESULTSNew areas of decreased
choriocapillaris perfusion were noted by fluorescein angiography in
the previous location of the CNV in 8/12 (75%) cases. Surgically
excised tissue contained retinal pigment epithelium (RPE) in 11/11
specimens and choriocapillaris in 1/11 specimen studied.
CONCLUSIONSChoriocapillaris atrophy may partly
underlie the limited visual outcome following subfoveal surgery for
AMD. Abnormal choriocapillaris perfusion following CNV excision may be
due to pre-existing choriocapillaris atrophy, to choriocapillaris
damage or removal at the time of surgery, or to RPE removal at surgery
with abnormal RPE repopulation of the dissected area and subsequent
choriocapillaris degeneration.
© 1997 by British Journal of Ophthalmology
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