Surgical removal of subfoveal choroid neovascularization in senile macular degeneration
1999
UNLABELLED: The follow-up of central scotomas and fixation--next to visual acuity--are important parameters for the evaluation of new therapies in AMD. PATIENTS AND METHODS: Twenty-three patients (age 67 to 91 years) with subfoveal CNV had SLO fundus-controlled perimetry before and 6-8 weeks after surgical removal of the CNV. The size and location of deep (0 dB) and relative (12 dB) scotomas were measured. Stability and location of fixation were analyzed. RESULTS: Fifty-six percent of patients gained (10% lost) more than 2 lines of VA; 52% of deep scotomas decreased in size (26% increased). No relative scotoma increased, but 63% decreased, some remarkably. Most scotomas had steeper borders postoperatively. Five of 7 patients were able to fixate again. Fixation moved slightly more peripheral in 4 patients and was otherwise unchanged. None of 7 patients whose fixation was close to their fovea preoperatively lost that fixation. CONCLUSION: Subfoveal surgery may stabilize the course of subfoveal CNV in AMD at 6 weeks follow-up. In some patients the major benefit can be a reduction of relative scotoma due to reattachment of the retina. As the location of fixation changes little with surgery and is typically located within the area of relative scotoma, visual function can improve.
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