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Susan B. Bressler, MD; Juan C. Silva, MD; Neil M. Bressler, MD; Judith Alexander; W. Richard Green, MD

Arch Ophthalmol. 1992;110(6):827-832.

Abstract
• 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.

Author Affiliations
From the Retina Vascular Center (Drs S. Bressler and N. Bressler and Ms Alexander) and the Eye Pathology Laboratory (Drs Silva and Green), Wilmer Ophthalmological Institute, The Johns Hopkins Medical Institutions, Baltimore, Md.

Footnotes
Accepted for publication November 25, 1991.

Reprint requests to Eye Pathology Laboratory, Maumenee 427, The Johns Hopkins Hospital, Baltimore, MD 21205 (Dr Green).

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