Surgical Removal of Subfoveal Neovascular Membranes

Lee, Se Youp; Lee, Jong Hwa; Kim, Kwang Soo

Abstract

Subretinal neovascularization(SRNV) can occur from any pathologic processes that result in an abnormality at the level of the retinal pigment epithelium (RPE)-Bruch's membrane-choriocapillaris complex. Especially, SRNV located under the foveal center usually has a poor visual prognosis. Recently, we undertook surgical removal of six consecutive subfoveal neovascular membranes in an attempt to restore and/or preserve central vision. The cause of SRNV in 3 eyes was age-related macular degeneration(ARMD) and 3 eyes idiopathic. Mean follow-up ranged 11.7 months. Overall visual improvement was achieved in 5 of 6 eyes and significant visual improvement(defined as 2 lines) was shown in 1 of 3 eyes with ARMD and in 2 of 3 eyes with idiopathic membrane. Subfoveal RPE was relatively intact in eyes with good visual outcome as compared to eyes with poor visual outcome. Post operative complication included cataracts(2), subretinal hemorrhages(2), and retinal detachment(1). Recurrence of subfoveal neovascular membranes, however, was not found throughout the follow-up period. These results suggested that subfoveal neovascular membranes can be surgically removed with improvement and/or stabilization of central vision. Visual prognosis depends on the intergrity of the subfoveal RPE after removal of the membrane.