Choroidal neovascularization in black patients
D. J. Pieramici, N. M. Bressler, S. B. Bressler and A. P. Schachat
Retinal Vascular Center, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Md.
OBJECTIVE: To characterize choroidal neovascularization (CNV) in black
patients examined at a retinal disease referral center. DESIGN:
Retrospective review of the medical records of all patients diagnosed as
having CNV to identify black patients with CNV. SETTING: Single tertiary
retinal referral center that included four ophthalmologists. PATIENTS: All
patients diagnosed as having CNV between April 1990 and October 1992. MAIN
OUTCOME MEASURES: Prevalence, demographic information, fundus photographic
and fluorescein angiographic characteristics, natural history, and response
to laser photocoagulation of CNV in black patients. RESULTS: Black patients
comprise 15% of all patients seen at this center. Of 1725 patients
identified as having CNV who were seen at the center during a 2.5-year
period, only 25 were black (1.4%). In these patients, CNV was associated
with a variety of retinal diseases, the most frequent being age-related
macular degeneration. The average age of the study group was 54 years,
women outnumbered men 2:1, and 13 of the patients developed bilateral
lesions. Twelve of the 38 lesions were extrafoveal on presentation, and
five of these were peripapillary. In the laser-treated eyes, recurrence of
CNV was frequent and associated with visual loss. CONCLUSIONS: Choroidal
neovascularization seems to be rare in blacks among a retinal disease
referral center population. The overall presentation, natural history, and
response to laser treatment seems to be similar to that of white patients.
No feature of CNV in black patients was identified that would suggest that
results of randomized clinical trials of laser photocoagulation for CNV are
not valid for these patients.
