Surgical excision of subfoveal neovascular membranes

Benson, M T; Callear, A B; Tsaloumas, M D; Chhina, Jas; Beatty, Stephen

doi:10.1038/eye.1998.200

Cited by 20 publications

(17 citation statements)

References 27 publications

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“…Moreover, these two predictors were intimately cross‐correlated. Our results of visual stabilization (73%) after excision of CNV not associated with AMD in younger patients is comparable to the 79–83% reported from earlier studies (Holekamp et al 1997; Berger et al 1997; Thomas et al 1994; Benson et al 1998). Also, the overall postoperative visual result for this age group stands out favorably in comparison with the natural course of presumed ocular histoplasmosis syndrome (POHS) associated with CNV where 77% of patients have a visual acuity of 0.1 or less in two years (Kleiner et al 1988).…”

Section: Discussionsupporting

confidence: 89%

The Swedish national survey of surgical excision for submacular choroidal neovascularization (CNV)

Berglin

Algvere

Olivestedt

et al. 2001

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To compare the visual outcome after surgical removal of subfoveal choroidal neovascularization (CNV) in patients younger and older than 50 years of age. Methods: Patient records from all Swedish centers performing submacular CNV surgery were reviewed and 90 patients treated between 1992-1999 with a follow-up of 6 months or more were included. The results obtained in 49 patients aged 51-89 years (medianΩ72 years) with neovascular disease caused by agerelated macular degeneration (AMD) were compared with the outcome of 41 patients aged 6-49 years (medianΩ36 years) with CNV secondary to non-AMD causes. The main outcome measure was the improvement or deterioration in visual acuity (standardized in logMAR units) at 6 months following surgery. Secondary endpoints were recurrent CNV and surgical complications. Results: The level of preoperative visual acuity was not significantly different between younger patients with CNV associated with non-AMD and older patients with visual loss due to AMD (pΩ0.069). However, visual acuity at 6 months after surgery was better (pΩ0.0042) in younger patients (median improvementΩ0.19 logMAR) than in older patients (median improvementΩ0.0 log MAR). Marked visual improvement (Ͼ1 log MAR unit) was seen in 29% of non-AMD patients ∞50 years compared to 0% in the AMD group Ͼ50 years. Conclusion: Surgical removal of submacular CNV does not appear to improve visual acuity in patients Ͼ 50 years of age. However, it may be beneficial for younger patients where a substantial improvement of visual acuity is seen in a subset of these patients. Further studies are required to assess the long-term outcome.

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Section: Discussionsupporting

confidence: 89%

The Swedish national survey of surgical excision for submacular choroidal neovascularization (CNV)

Berglin

Algvere

Olivestedt

et al. 2001

Acta Ophthalmologica Scandinavica

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“…67 Submacular surgery for CNV in pathological myopia Submacular surgery has been evaluated for myopic CNV in several studies with differing outcomes. [68][69][70][71][72][73] Most earlier studies were small case series and larger series had conflicting results. [71][72][73] After a mean 16 months of follow up, VA improved by at least two lines in 45% and remained stable in 37% of 65 eyes with subfoveal myopic CNV in a study by Bottoni et al 71 Uemura et al reported 48 patients who underwent removal of subfoveal myopic CNV; VA improved in 39% and remained unchanged in 26% after a mean follow up of 24 months.…”

Section: Extrafoveal Myopic Cnvmentioning

confidence: 99%

Choroidal neovascularisation in pathological myopia: an update in management

Chan

Ohji²,

Lai³

et al. 2005

British Journal of Ophthalmology

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“…Therapeutic approaches to slow down the vision loss consisted mainly of conventional thermal laser [11], PDT [12] or transpupillary thermotherapy [22]. Surgical approaches like subretinal membrane extraction [23] or macular rotation [24] are more invasive and provide a high risk of intra- and postoperative complications as e.g. retinal detachments.…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Experimentally Induced Choroidal Neovascularizations in Pigmented Rabbits by Subretinal Injection of Lipid Hydroperoxide and Consecutive Preliminary Photodynamic Treatment with Tookad

Framme

Sachs²,

Kobuch³

et al. 2008

Ophthalmologica

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Purpose: Up to date several approaches have been undertaken to achieve an ‘easy-to-handle’ animal model of choroidal neovascularizations (CNVs) in rabbits; however, so far in none of the studies could healthy retinal tissue be maintained, which is mandatory to further investigate the effects of photodynamic therapy (PDT) or anti-vascular-endothelial-growth-factor treatments. It was our aim to reevaluate and verify the method of inducing experimental CNVs in rabbits using subretinally injected linoleic acid hydroperoxide (LHP) as proposed by Tamai et al. and to use it for experimental PDT. Material and Methods: In 33 eyes of Chinchilla breed rabbits LHP of two different concentrations (25 and 100 µg/50 µl) was injected into the subretinal space via a transvitreal approach under guidance of an operation microscope. Ophthalmoscopic and angiographic examinations were performed on days 3, 7, 14 and 28 after surgery. Preliminary PDT with different experimental parameter sets was performed in 3 eyes using the new photosensitizer Tookad. Results: Using LHP in the higher concentration, an angiographically determined CNV induction was observed in 27% of all injection sites (n = 34) on days 14 and 28 revealing early well-demarcated and progressive leakage. No CNV was detected at the lower LHP concentration (60 injection sites). Subretinal CNV was verified histologically revealing vessel formation above the retinal pigment epithelium level. Herein, a significant damage to the outer retinal layers was always observed; however, the general structure of the choriocapillary layer was maintained. Tookad PDT was clinically able to completely stop leakage in 1 case and reduce leakage in 2 cases. Histologically the choriocapillary layer was occluded. Conclusion: Subretinal injection of LHP induces angiographically well-demarcated classic CNVs in rabbits; however, the CNV rate was low, and histology revealed severe damage of the outer retinal layers but not of the choriocapillary layer, which is important for studying PDT interactions. Preliminary experimental PDT could clinically stop or reduce leakage from angiographic CNV. Due to the small CNV rate and the significant collateral retinal tissue damage, this model seems to be only of partial suitability for investigating new treatment modalities in CNV.

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Surgical excision of subfoveal neovascular membranes

Abstract: Background Sub foveal choroidal neovascular

Cited by 20 publications

References 27 publications

The Swedish national survey of surgical excision for submacular choroidal neovascularization (CNV)

The Swedish national survey of surgical excision for submacular choroidal neovascularization (CNV)

Choroidal neovascularisation in pathological myopia: an update in management

Clinical Evaluation of Experimentally Induced Choroidal Neovascularizations in Pigmented Rabbits by Subretinal Injection of Lipid Hydroperoxide and Consecutive Preliminary Photodynamic Treatment with Tookad

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