Outcome of Macular Translocation in Young Patient With Subfoveal Neovascularization, Either Associated With Choroiditis or Idiopathic

Abstract

Abstract: : Purpose: To study the visual outcome of eyes with subfoveal neovascularization in young patients, either associated with choroiditis or idiopathic, after macular translocation. Methods: Ten eyes with idiopathic subfoveal neovascularization (5 eyes) or choroiditis (5 eyes) underwent limited macular translocation (DeJuan technique). According to the location of the membrane, the macular was shifted inferiorly (5 eyes) or nasally (5 eyes). Results: Mean age of the patients (6 women and 4 men) was 39 years. Six eyes presented with moderate myopia (mean, –2.8 D). Visual acuity ranged preoperatively from counting fingers to 20/64. Macular translocation resulted in a mean displacement of the fovea of ½ disc diameter. Laser photocoagulation of newly extrafoveal neovascular membrane was performed in 8 eyes, and surgical removal was performed secondarily in 2 eyes. Neovascular recurrence was observed in 2 eyes postoperatively, at 2 and 9 months follow–up. This recurrence remained extrafoveal in both eyes and was treated with laser, resulting in the loss of 1 ETDRS line in 1 eye. At a mean follow–up of 12 months, visual acuity improvement was in average 4 lines. Retinal detachment was observed in one eye during follow–up. Postoperative visual acuity was of 20/50 or more in 90% of patients, and in 80% at the end of follow–up. Mean visual gain was 4.8 ETDRS lines. Conclusions: Visual results in this series are all the more encouraging, since no treatment until now have proven efficacy in these eyes. The benefit of macular translocation is the displacement of the fovea away from the neovascular membrane, and to allow additional photocoagulation in case of recurrence. Larger multicenter randomized trial is needed to confirm these results.

Keywords: choroid: neovascularization • vitreoretinal surgery • chorioretinitis