ABSTRACT
PURPOSE: To assess the two year outcome following macular translocation (MT) with scleral infolding in the management of myopic subfoveal choroidal neovascularisation (CNV). DESIGN: Prospective, clinical interventional noncomparative consecutive case series. PARTICIPANTS: 79 eyes of 79 patients with myopic subfoveal CNV and less than 6 months of duration of the symptoms. INTERVENTION: MT with scleral infolding. MAIN OUTCOME MEASURES: Visual Acuity (VA), reading ability of 12 point Arial letter sentences at a reading distance without magnifying systems and foveal displacement. RESULTS: Mean preoperative VA was 20/125, after two years the mean VA was 20/80. Reading ability of 12 point Arial letter sentences at a reading distance (33 cm) was obtained in 59% of the eyes at one year, descending to 43% at two years. Mean foveal displacement after surgery was 942 microns. Intraoperative complications have been: retinal breaks (21.5%) and choroidal haemorrhage not affecting the posterior pole (3.7%). Main postoperative complications have been: Insufficient foveal displacement: 20%; Retinal detachment: 8.8%; Subfoveal recurrence: 28%; macular fold: 2.5% and macular hole: 1.2%. CONCLUSION: MT with scleral infolding offers the opportunity to recover central vision and reading ability in patients with myopic CNV but it remains unpredictable.
Subject(s)
Choroidal Neovascularization/surgery , Myopia, Degenerative/surgery , Sclera/surgery , Adolescent , Adult , Aged , Choroidal Neovascularization/etiology , Female , Fluorescein Angiography , Fundus Oculi , Humans , Macula Lutea/surgery , Male , Middle Aged , Myopia, Degenerative/complications , Ophthalmologic Surgical Procedures , Postoperative Complications , Prospective Studies , Time Factors , Treatment Outcome , Visual AcuityABSTRACT
PURPOSE: To assess the anatomical and functional results after surgical removal of peripapillary choroidal neovascularization (CNV) associated with optic nerve head drusen. METHODS: A retrospective study was carried out on four eyes (four patients) undergoing vitrectomy, retinotomy, and removal of CNV associated with optic disk drusen. CNV was preoperatively demonstrated by fluorescein angiography in all cases. In three cases, the CNV had a subfoveal extension, and a serous-hemorrhagic retinal detachment was the cause of the central vision disturbance in the remaining one. Optic nerve head drusen were bilateral and were confirmed with computed tomography scan. RESULTS: Visual acuity (VA) improved in all cases after a follow-up ranging from 12 to 42 months. Preoperative VA was 20/200, 20/200, 20/50, and count fingers and final VA was 20/50, 20/25, 20/25, and 20/30, respectively. There was no evidence of CNV recurrence during the follow-up period. CONCLUSION: The results of surgical removal of peripapillary CNV with macular involvement associated with optic nerve head drusen are very encouraging, especially if we consider the variable outcome of the natural course in these cases.
