Surgical Management of Subfoveal Choroidal Neovascularization

Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration

“…Many investigators have reported improved visual acuity in patients with ARMD after resection of CNV (de Juan & Machemer 1988;Lambert et al 1992;Thomas et al 1992) or removal of extensive subretinal hemorrhage (Ibanez et al 1995;Lewis 1995;Kamei et al 1996). This has been made possible by improvements in the surgical instruments and techniques used for subretinal procedures (Thomas & Ibanez 1994).…”

“…(ARMD) may be treated in several different ways, including photocoagulation (Macular Photocoagulation Study Group 1991Group , 1993Group , 1994Hawkins 1994), radiation therapy (Bergink et al 1994), pharmacologic therapy (Thomas & Ibanez 1993;Miller et al 1993;Gillies et al 1993;Chan et al 1994;Poliner et al 1994), and invasive intervention, such as a vitrectomy for the removal of subretinal hemorrhage (Ibanez et al 1995;Lewis 1995;Kamei et al 1996) or resection of choroidal neovascularization (CNV) (de Juan & Machemer 1988;Lambert et al 1992; Thomas et al 1992). Despite the merits of these procedures, photocoagulation of subfoveal CNV sometimes worsens visual acuity, radiation therapy is often complicated by a high incidence of recurrence, and pharmacologic therapy, such as interferon-å (Thomas & Ibanez 1993;Miller et al 1993;Gillies et al 1993;Chan et al 1994;Poliner et al 1994), often produces inconsistent results.…”

“…Despite the merits of these procedures, photocoagulation of subfoveal CNV sometimes worsens visual acuity, radiation therapy is often complicated by a high incidence of recurrence, and pharmacologic therapy, such as interferon-å (Thomas & Ibanez 1993;Miller et al 1993;Gillies et al 1993;Chan et al 1994;Poliner et al 1994), often produces inconsistent results. Pars plana vitrectomy to resect CNV has met with some success in recent years (de Juan & Machemer 1988;Lambert et al 1992; Thomas et al 1992). However, on occasion this results in marked damage to the retinal pigment epithelium with limited postoperative improvement in vision (Hudson et al 1995;Rosa et al 1996).…”

Autologous translocation of the choroid and RPE in age-related macular degeneration: 1-year follow-up in 30 patients and recommendations for patient selection

“…It is known that surgical extraction of the choroidal neovascularization (CNV) in these patients is technically feasible; 4,5 however, it did not improve nor preserve visual acuity (VA) over 24 months in randomized trials. 6 Peyman first suggested translocation of peripheral choroid and retinal pigment epithelium (RPE) in order to supplement transplanted pigment epithelium with the underlaying intact Bruch's membrane and choroid.…”

Surgical Removal vs Observation for Subfoveal Choroidal Neovascularization,Either Associated With the Ocular Histoplasmosis Syndrome or Idiopathic

“…This group of patients was judged to be the one in which submacular surgery held the most promise of providing a benefit with respect to future vision, based on reports from uncontrolled case series. [23][24][25] Moreover, no other treatment had been documented to benefit these patients. Although the benefits of laser photocoagulation for treating extrafoveal and juxtafoveal CNV arising from the same conditions were demonstrated by the Macular Photocoagulation Study Group, 12-18 investigators who participated in a small pilot study reported that there was no benefit to laser photocoagulation of subfoveal CNV secondary to ocular histoplasmosis.…”