Submacular Surgery for Subfoveal Choroidal Neovascular Membranes in Patients With Presumed Ocular Histoplasmosis
Adam S. Berger, MD;
Mandi Conway, MD;
Lucian V. Del Priore, MD, PhD;
Rebecca S. Walker, MD;
John S. Pollack, MD;
Henry J. Kaplan, MD
Arch Ophthalmol. 1997;115(8):991-996.
Abstract
| |
Objective
To determine the visual results, recurrence rates, and postoperative complications of surgical removal of subfoveal choroidal neovascularization (CNV) in patients with the presumed ocular histoplasmosis syndrome.
Design
A consecutive surgical series of 63 eyes of 62 patients with subfoveal CNV and the presumed ocular histoplasmosis syndrome with longer than 6 months of follow-up.
Setting
Tertiary care university medical center.
Methods
Patients underwent surgical removal of subfoveal CNV using vitreoretinal surgical techniques. The anatomical and functional results of surgery were analyzed.
Results
The median age of the patients was 42 years (range, 16-68 years), and the median follow-up time was 24 months (range, 6-48 months). Visual acuity improved by 2 or more Snellen lines in 22 (35%) of the 63 eyes, was unchanged in 28 (44%) of the eyes, and worsened in 13 (21%) of the eyes. Eleven (17%) of the 63 eyes improved to a visual acuity of 20/50 or better. Eyes with an initial visual acuity of 20/200 or worse had a better prognosis for improved vision (ie, 26 [41%] of the eyes) than those with an initial visual acuity of 20/100 or better (ie, 5 [8%] of the eyes). Recurrence of the subfoveal CNV occurred in 24 (38%) of the 63 eyes and was more common in those eyes that received preoperative laser photocoagulation (ie, 15 [47%] of the eyes). The median time to recurrence was 5 months after surgery. Postoperative complications included macular striae in 4 (6%) of the 63 eyes, rhegmatogenous retinal detachment in 2 (3%) of the eyes, retinal tear in 1 (1.6%) of the eyes, and progression of cataract in 19 (30%) of the eyes.
Conclusions
Surgical excision of subfoveal CNV may be an effective therapeutic modality in patients with the presumed ocular histoplasmosis syndrome that offers the possibility of improving central vision in many patients. Factors possibly associated with a favorable visual prognosis include younger patient age and the absence of previous laser photocoagulation.
Author Affiliations
From the Barnes Retina Institute and the Department of Ophthalmology and Visual Sciences, Washington University, St Louis, Mo.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Two-year results of surgical removal of choroidal neovascular membranes related to non-age-related macular degeneration
Essex et al.
Br J Ophthalmol 2007;91:649-654.
ABSTRACT
| FULL TEXT
Photodynamic therapy for inflammatory choroidal neovascularisation unresponsive to immunosuppression
Leslie et al.
Br J Ophthalmol 2005;89:147-150.
ABSTRACT
| FULL TEXT
Immunotherapy for choroidal neovascularization in a laser-induced mouse model simulating exudative (wet) macular degeneration
Bora et al.
Proc. Natl. Acad. Sci. USA 2003;100:2679-2684.
ABSTRACT
| FULL TEXT
Visual Outcome After Surgical Removal of Choroidal Neovascularization in Pediatric Patients
Uemura and Thomas
Arch Ophthalmol 2000;118:1373-1378.
ABSTRACT
| FULL TEXT
Prevention of visual field defects after macular hole surgery
Cullinane and Cleary
Br J Ophthalmol 2000;84:372-377.
ABSTRACT
| FULL TEXT
Subretinal Surgery for Choroidal Neovascularization in Patients With High Myopia
Uemura and Thomas
Arch Ophthalmol 2000;118:344-350.
ABSTRACT
| FULL TEXT
OCT imaging of choroidal neovascularisation and its role in the determination of patients' eligibility for surgery
Giovannini et al.
Br J Ophthalmol 1999;83:438-442.
ABSTRACT
| FULL TEXT
Submacular Surgery: New Information, More Questions
Bressler
Arch Ophthalmol 1997;115:1071-1072.
ABSTRACT
|
