The visual outcome of peripapillary choroidal neovascular membranes

Abstract

Twenty eyes with age related peripapillary choroidal neovascular membranes were studied retrospectively to establish visual outcome in relation to treatment with argon laser, position and size. There was no statistical difference in final visual acuity in relation to laser treatment, size of membrane, nor position of the membrane at presentation. Despite these findings, there is evidence that laser treatment may delay the progression of visual loss.

Treating peripapillary choroidal neovascular membranes: a review of the evidence

“…The results showed no statistical significance on visual outcome with respect to position or size of membrane. 2 Moreover, there was no association between laser and visual outcome. Interestingly, this paper did show that small membranes, situated outside the macular vascular arcades have a good prognosis, regardless of whether treatment or conservative regime is adopted.…”

“…4 It has been shown that better outcomes are seen in treating membranes early, whilst they are small and don't affect visual acuity (VA). 2 The aim is to treat before the membrane encroaching the fovea, but the largest obstacle is these types of membranes generally are asymptomatic up until that stage.…”

“…A retrospective analysis over a 10-year period from the Western Eye Hospital, London, compared the final visual outcomes after Argon laser treatment in relation to position and size of the membrane. 2 A total of 12 patients were treated with an average of two sessions per patient. Eighty percent of the PCNM arose temporal to the disc, closest to the fovea.…”

“…1 PCNMs account for 10% of all choroidal neovascular membranes with a female predilection. 2 A large period of time can elapse between the anatomical onset of the disease and visual deterioration. Clinical manifestations only occur if the membrane extends over the macula, if the vessels haemorrhage into the subretinal space, or fluid exudation occurs within the macula.…”

Pragmatism versus purity: effectiveness of the key informant methodology in a developing rural setting

“…On the other hand, no statistical difference in final VA following laser treatment for AMD-PPCNV was reported by Ruben et al in 1994. 11 In Browning and Fraser's survey, 4 73 of 115 eyes with PPCNV of various origins underwent laser treatment; in 14 (19.2%) a recurrence was noted, and multiple recurrences occurred in four (5.5%). Comparable results with recurrence rates of 20% and 28% were reported by Annesley et al 12 and Cialdini et al 13 Finally, in the Macular Photocoagulation Study PPCNV subgroup, there was no improvement in visual outcome with laser ablation over three years of untreated follow up; furthermore, there was no significant difference in the rates of severe vision loss between treated and untreated eyes.…”