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At least 19 recordsLinked to original sources
PubMed1986

Choroidal neovascularization.

Choroidal neovascularization is now considered to be a most important feature in the pathogenesis and treatment of a number of chorioretinal disorders. Since the recognition of its importance, choroidal neovascularization has been described in clinical and pathologic studies of a variety of different ophthalmologic conditions. We have summarized the diseases in which choroidal neovascularization occurs and have reviewed studies on the natural history, clinical findings, and therapy of choroidal neovascularization that provide the basis for the current management of this condition.

Aged↗
PubMedDate not supplied

Diseases of the macula: the diagnosis and management of choroidal neovascularization.

Choroidal neovascularization is the major complication of several macular diseases. Criteria for the selection of patients for consideration of photocoagulation treatment are presented. The distance of the foveal edge of the choroidal new vessel membrane to the center of the fovea is the most important criterion in considering the patient for photocoagulation. Photocoagulation is not considered unless the edge of the new vessel membrane is at least one fourth disc diameter (375micron) from the center of the fovea. Randomized controlled studies are required to document the role of photocoagulation therapy for choroidal neovascularization.

Adult↗
PubMed1992

Choroidal neovascularization associated with choroidal hemangiomas.

Two patients with choroidal hemangiomas developed choroidal neovascularization. One patient with Sturge-Weber syndrome, a unilateral diffuse choroidal hemangioma, and a serous detachment of the macula was treated with yellow dye laser photocoagulation in a grid pattern to the tumor before glaucoma filtration surgery. Four years after successful laser treatment, the patient developed subfoveal choroidal neovascularization in an area of treatment. A second patient with a circumscribed choroidal hemangioma developed spontaneous subfoveal choroidal neovascularization 12 years after initial diagnosis of the hemangioma. The development of choroidal neovascularization associated with choroidal hemangiomas represents a potential cause of poor visual outcome in these patients.

Adolescent↗
PubMed1978

Choroidal neovascularization associated with choroidal nevi.

We observed choroidal neovascularization with associated macular detachment in three cases of benign choroidal nevi. Successful obliteration of the neovascular membranes was performed with argon laser photocoagulation with maintenance of good central visual acuity.

Adult↗
PubMed1992

Surgical management of subfoveal choroidal neovascularization.

BACKGROUND: Subfoveal choroidal neovascularization (CNV) usually is associated with a poor visual prognosis. Laser photocoagulation of certain subfoveal membranes secondary to age-related macular degeneration (ARMD) appears preferable to observation based on recent Macular Photocoagulation Study (MPS) findings but is associated with decreased vision. The authors explored the use of vitreoretinal surgical techniques as an alternative method of eradicating subfoveal CNV. METHODS: After vitrectomy, a small retinotomy technique was used to extract or disconnect from the choroidal circulation subfoveal CNV in 58 eyes. There were 33 eyes with ARMD, 20 eyes with presumed ocular histoplasmosis, and 5 eyes with miscellaneous etiologies. Five eyes also received subfoveal RPE patches. RESULTS: With limited follow-up, significant improvement in vision (defined as 2 Snellen lines) was achieved in 7 of 22 eyes with ARMD CNV removal (1 eye 20/20), 0 of 4 eyes with ARMD CNV removal and RPE patches, and 1 of 7 eyes with ARMD CNV disconnection. Significant improvement was achieved in 6 of 16 eyes with presumed ocular histoplasmosis removal and 0 of 4 eyes with presumed ocular histoplasmosis CNV disconnection. In 5 eyes with miscellaneous CNV, 2 improved (20/20 and 20/40). CNV recurred in 29%. CONCLUSIONS: Some patients with subfoveal CNV appear to benefit from surgical removal. Only rarely do eyes with ARMD improve. Longer-term follow-up and refined case selection are required before this approach can be widely recommended.

Aged↗
PubMed1992

Visual symptoms associated with choroidal neovascularization. Photopsias and the Charles Bonnet syndrome.

One hundred consecutive patients with macular choroidal neovascularization were studied in a cross-sectional fashion. Evidence of bilateral choroidal neovascularization was present in 31 patients. Among the 100 subjects, 59% related a history of seeing flickering or flashing lights (photopsias) in the affected eye or eyes. The colors varied, but in 59% of instances the lights were white. Twelve subjects experienced formed hallucinations (Charles Bonnet syndrome); in nine (75%) of these patients, the sequelae of choroidal neovascularization were bilateral. Symptoms that are commonly attributed to vitreoretinal tractional phenomena as well as neurologic and/or psychiatric disease are also frequently encountered in patients with macular degeneration associated with choroidal neovascularization.

Adult↗
PubMed1992

[Laser photocoagulation of experimentally produced choroidal neovascularization. 2. Comparison of effects by dye and argon blue-green lasers].

Choroidal neovascularization was produced in 18 eyes of 12 rhesus monkeys by application of intense krypton laser photocoagulation. Eight weeks or later, a total of 34 choroidal neovascularizations were treated either by dye laser at wavelengths of 577 or 630 nm or by argon blue-green laser. The treated lesions were evaluated clinically and histopathologically from 24 hours to 3 months after treatment. All the treated lesions were apparently healed by each of the 3 laser modalities. Histopathologically, all the treated choroidal neovascularizations were occluded 24 hours after treatment. At 2 weeks to 3 months after treatment, newly-formed choroidal vessels were present in 3 of 9 lesions (33%) after 577 nm dye laser treatment, in 8 of 9 lesions (89%) after 630 nm dye laser treatment, and in 5 of 8 lesions (62%) after argon blue-green laser. These results seemed to show the clinical superiority of 577 nm dye laser in treating choroidal neovascularization.

Animals↗
PubMed1990

Treatment of foveal pigment epithelial detachments with contiguous extrafoveal choroidal neovascular membranes.

Fourteen eyes of 14 patients who had subfoveal retinal pigment epithelial detachments and extrafoveal contiguous choroidal neovascular membranes associated with age-related macular degeneration underwent laser photo-coagulation treatment directed solely to their choroidal neovascular membrane. In eight of 14 eyes (57%), photocoagulation treatment resulted in closure of the choroidal neovascular membrane with subsequent collapse of the pigment epithelial detachment. Six of the eight eyes also had visual improvement. In six of 14 eyes (43%), the neovascular membrane eventually progressed into the fovea with resultant visual loss. The results of our study suggest that photocoagulation of extrafoveal choroidal neovascular membranes associated with foveal detachments of the retinal pigment epithelium may preserve and even improve visual function in affected patients.

Aged↗
PubMed1987

Clinical characteristics of choroidal neovascular membranes.

Eighty-three choroidal neovascular membranes (CNVMs) associated with pathologic entities other than age-related macular degeneration (study group) were compared with 64 CNVMs associated with macular degeneration (comparison group). Nine CNVMs (11%) in the study group, compared with 28 CNVMs (44%) in the comparison group, were occult membranes. Of the remaining well-defined CNVMs, 16 (22%) in the study group, compared with 21 (58%) in the comparison group, were subfoveal. Of the well-defined subfoveal membranes, four (25%) in the study group, compared with 17 (81%) in the control group, were large (greater than 1500 micron in size). All large subfoveal membranes occurred in patients over 55 years of age. Thus, in this study the majority of CNVMs associated with pathologic entities other than age-related macular degeneration were well defined and not subfoveal at initial presentation. The majority of CNVMs associated with macular degeneration were occult or subfoveal. Membranes in patients over 55 years of age, regardless of cause, were commonly found to be occult or subfoveal at presentation.

Adolescent↗
PubMedDate not supplied

Clinicopathologic correlation of krypton and argon laser photocoagulation in a patient with a subfoveal choroidal neovascular membrane.

Krypton-red laser photocoagulation for choroidal neovascular membranes has been shown to produce inner retinal sparing in contrast to argon blue-green or argon-green laser photocoagulation, which causes full-thickness retinal destruction. However, previous histopathologic reports have involved only primates or humans without known macular degeneration. Clinicopathologic features of a case in which a human eye with a choroidal neovascular membrane, associated with age-related macular degeneration, was photocoagulated on four occasions with the argon-green and krypton-red lasers are presented. The results of this study confirm previous reports of the inner retinal sparing noted with krypton-red laser photocoagulation in comparison with argon blue-green or argon-green laser photocoagulation.

Aged↗
PubMed1988

Juxtapapillary choroidal neovascularization in older patients.

We studied retrospectively 55 eyes with juxtapapillary choroidal neovascularization in 42 patients over the age of 50 years. In all but four lesions, the choroidal neovascularization was undetected, causing the choroidal new vessel complexes to be ill defined, discontinuous, and show irregular dye leakage on fluorescein angiography. Growth of the lesion was unpredictable. Visual loss occurred in eight of 16 eyes during the first six months of follow-up. Recurrent neovascularization after photocoagulation originated in some patients from outside the pretreatment subretinal complex. Of the 15 patients with bilateral involvement, 13 had juxtapapillary lesions. Fellow eyes in patients with unilateral juxtapapillary lesions showed no predisposing abnormality at or near the nerve head. The prevalence, density, and fluorescein angiographic characteristics of drusen were different from those in age- and sex-matched patients with macular neovascularization.

Aged↗
PubMed1991

Clinicopathologic studies of treated choroidal neovascular membranes. A review and report of two cases.

The previously reported and two additional clinicopathologic studies of treated choroidal neovascular membranes were reviewed. Laser photocoagulation can obliterate choroidal neovascular membranes, but persistent and recurrent neovascularization contiguous with the treated area or the development of a new area of neovascularization contiguous or not contiguous with the treated area was seen histopathologically in nine of 12 (75%) lesions of 10 eyes. The scar that ensues after photocoagulation resembles the naturally occurring scar associated with choroidal neovascularization. Portions of the scar are comprised of hyperplastic retinal pigment epithelium. The inner retinal layers are more likely to be preserved after krypton red photocoagulation. Full-thickness destruction of the retina occurs with argon blue-green and argon green photocoagulation at levels of energy in which the end point is a uniform, white lesion.

Aged↗
PubMedDate not supplied

Choroidal neovascularization in children: report of five cases and literature review.

Choroidal neovascularization is rare in the pediatric population. It has been associated in this age group with a variety of conditions. Increasing ability to treat these neovascular lesions with laser photocoagulation makes early recognition very important for visual preservation. An overview is presented, including an updated list of conditions associated with choroidal neovascularization in children and adolescents. Guidelines to recognition, parent and patient instructions, and the selective use of fluorescein angiography are emphasized. Five illustrative cases are highlighted, including a 10-year-old boy successfully treated with krypton laser photocoagulation near the fovea.

Adolescent↗
PubMed1985

Important points in management of patients with choroidal neovascularization.

The efficacy of argon blue-green laser treatment for extrafoveal choroidal neovascularization (CNV) in aging macular degeneration, presumed ocular histoplasmosis syndrome and idiopathic choroidal neovascularization has recently been proven by the Macular Photocoagulation Study. These results are applicable only to eyes managed according to certain principles of therapy and post-treatment follow-up. These include the use of a recent fluorescein angiogram and retrobulbar anesthetic, aiming for complete obliteration of the CNV. Meticulous post-treatment follow-up is critical. This includes daily patient monitoring of the Amsler grid, and prompt examinations if distortion is noted. Excellent quality fluorescein angiography is mandatory. This is repeated frequently and studied promptly. Residual or recurrent extrafoveal CNV requires prompt re-treatment.

Choroid↗
PubMed1992

Clinicopathologic correlation of occult choroidal neovascularization in age-related macular degeneration.

We report the clinicopathologic features of an eye with occult choroidal neovascularization associated with age-related macular degeneration. Ophthalmoscopic findings at presentation included subretinal fluid and lipid. We noted angiographic staining of irregularly elevated areas of retinal pigment epithelium. In the late phase of the angiogram, fluorescein leakage at the level of the outer retina was observed that did not correspond to well-demarcated areas of hyperfluorescence in earlier phases. The patient was randomized to treatment in a pilot trial comparing the effects of grid laser treatment with the effects of no treatment for occult choroidal neovascularization. Three weeks after treatment, some of the subretinal fluid had cleared and vision improved. The patient died 6 weeks after laser treatment. Histopathologic study disclosed a subretinal pigment epithelial fibrovascular membrane. Neovascularization originated from the choroid.

Aged↗
PubMed1991

Loculated fluid. A previously undescribed fluorescein angiographic finding in choroidal neovascularization associated with macular degeneration. Macular Photocoagulation Study Reading Center.

The Foveal Photocoagulation Study, a component of the Macular Photocoagulation Study, is designed to evaluate whether laser treatment can reduce the risk of severe visual loss in eyes with well-defined choroidal neovascular membranes associated with macular degeneration that extend through the foveal center. On one third of the 554 baseline angiograms of study patients enrolled in and whose eyes were graded in the study as of January 31, 1990, the Reading Center staff has noted an unusual pattern of hyperfluorescence in the late-transit frames that has not been described previously. This pattern, which we call "loculated fluid," consists of a well-demarcated area of hyperfluorescence that appears to represent pooling of fluorescein in a compartmentalized space anterior to the choroidal neovascular leakage. Although the loculated fluid may conform to a pattern of typical cystoid macular edema, it can also pool within an area deep to the sensory retina in a shape that does not bear any resemblance to cystoid macular edema. This pattern is important to recognize because it (1) should not be confused with the angiographic pattern or extent of choroidal neovascularization and (2) should be differentiated from a serous detachment or tear of the retinal pigment epithelium.

Body Fluids↗
PubMedDate not supplied

Indirect photocoagulation of subfoveal choroidal neovascularization in age-related macular degeneration.

Forty consecutive patients with age-related macular degeneration and a choroidal neovascular membrane in the center of the macula were treated by dye laser photocoagulation. After a mean 24 month follow-up period, 21 patients (52.5%) remained stable or improved in vision. Of 21 patients with initial visual acuity of 20/100 or better, 11 patients (52%) remained 20/100 or better. In the control group only four patients (25%) remained stable or improved, and only two (15%) remained 20/100 or better. The theoretical and clinical advantages of the indirect laser treatment of subfoveal choroidal neovascular membranes in age-related macular degeneration are discussed.

Age Factors↗