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F. Ziemssen, F. Gelisken, S. Grisanti, W. Inhoffen, K.–U. Bartz–Schmidt; Analysis of Recurrent Choroidal Neovascularization after Macular Translocation with 360° Retinotomy for Neovascular Age–related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2002.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the functional and morphological outcome of recurrent choroidal neovascularization (CNV) after macular translocation (MT–360°) for neovascular age–related macular degeneration (AMD). Methods: This retrospective study includes all consecutive patients who underwent MT–360° for neovascular AMD between July 2001 and March 2003, with a follow–up of at least 6 months. All patients had subfoveal CNV lesion. Visual acuity examination was performed using a standardized protocol. Fundus photography and stereoscopic fluorescein angiography were performed preoperative and in three month intervals postoperatively. Initial lesion size, characteristics of recurrent CNV and treatment procedures were noted. Results: 30 eyes of 30 patients (16 women and 14 men, range in age 66–92 years) were analysed that fulfilled the inclusion criteria. The median follow–up was 19,5 months (range, 7–28 months). Preoperative size of the total lesion (CNV and other lesion components) was three Macular Photocoagulation Study disc areas (range, 1–14 disc areas). Six patients had extensive subretinal hemorrhage at the macula, three patients had pure occult or minimal classic CNV and 21 patients had classic or predominant classic CNV. The best–corrected visual acuity (logMAR score) improved from 0,90 (range 0,4 – 1,5) to 0,78 (range 0,2 – 1,3) at the last follow–up. 60% (18/30) of the eyes developed recurrent CNV. 83% (15/18) of the recurrent CNV was extrafoveal, 6% (1/18) showed juxtafoveal and 11% (2/18) subfoveal CNV, respectively. In this group, we found persistent or new recurrent CNV after initial treatment in 39% (7/18). 70% (19/27) of the recurrent CNV was treated by conventional laser photocoagulation and 15% (4/27) underwent photodynamic therapy Conclusions: In our study 60% of the eyes showed recurrent CNV after macular translocation for neovascular AMD in a mean follow–up of 19.5 months. Early treatment of recurrent CNV was associated with favourable visual prognosis. Since the majority of the recurrent CNV's after MT–360° were extrafoveal, regular follow–up examination with fluorescein angiography is recommended.
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