Chorioretinal damage caused by the excision of choroidal neovascularization

• Published in: American journal of ophthalmology Vol. 126; no. 3; pp. 348 - 357
• Main Authors: Tsujikawa, Motokazu, Sawa, Miki, Lewis, John M, Motokura, Masanobu, Tsujikawa, Kaoru, Ohji, Masahito, Saito, Yoshihiro, Tano, Yasuo
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1998; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Choroid - blood supply; Choroid - injuries; Choroid - pathology; Choroid Diseases - etiology; Choroid Diseases - pathology; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Humans; Indocyanine Green; Intraoperative Complications; Macular Degeneration - complications; Male; Medical sciences; Middle Aged; Neovascularization, Pathologic - etiology; Neovascularization, Pathologic - surgery; Ophthalmology; Prospective Studies; Retina - injuries; Retina - pathology; Retinal Diseases - etiology; Retinal Diseases - pathology; Retinopathies; Visual Acuity; Human; Retinopathy; Excision; Pigment epithelium; Choroid; Retina; Eye disease; Treatment; Surgery; Complication; Blood capillary; Lesion; Neovascularization
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(98)00089-0

PURPOSE: To determine whether choroidal neovascularization excision causes mechanical damage to the neurosensory retina, retinal pigment epithelium, or choriocapillaris. METHODS: Prospectively, 18 eyes of 18 consecutive patients who underwent choroidal neovascularization excision were observed. Preoperatively and postoperatively, the integrity of the choriocapillaris circulation in the pathway of choroidal neovascularization extraction was studied by fluorescein and indocyanine green angiography. Using static scanning laser ophthalmoscope microperimetry, the presence of iatrogenic scotomas that developed postoperatively in the pathway of choroidal neovascularization extraction was also investigated. RESULTS: Postoperatively, a choriocapillaris defect was detected in 17 (94.4%) of 18 cases. In 15 cases (83.3%), the choriocapillaris defect had a clear relationship to the pathway of choroidal neovascularization extraction. Postoperatively, a scotoma was present in 16 (88.9%) of 18 cases. In 14 cases (77.8%), the location of the scotoma had a clear relationship to the pathway of choroidal neovascularization extraction. CONCLUSION: Surgical excision of choroidal neovascularization leads to severe damage of the choroid and retina in the pathway of the extracted choroidal neovascularization. The injury involves the neurosensory retina, retinal pigment epithelium, and choriocapillaris.