TY - JOUR
T1 - Subfoveal choroidal neovascularization in punctate inner choroidopathy
T2 - Surgical management and pathologic findings
AU - Olsen, T. W.
AU - Capone A., Jr
AU - Sternberg P., Jr
AU - Grossniklaus, H. E.
AU - Martin, D. F.
AU - Aaberg, Sr
N1 - Funding Information:
Originally received: March 28, 1996. Revision accepted: August 20, 1996. From the Department of Ophthalmology, Emory University, Atlanta. Supported by a Heed and Heed/Knapp Ophthalmic Foundation fellbwship award (Dr. Olsen), Cleveland Clinic, Cleveland, Ohio, a departmental grant from Research to Prevent Blindness, Inc, New York, New York, and departmental NIH core grant EY 06030, Bethesda, Maryland. The authors have no proprietary interest in any drug or piece of equipment used in this study. Reprint requests to Antonio Capone, Jr, MD, Department of Ophthalmology, Emory University, l365B Clifton Rd NE, Atlanta, GA 30322.
PY - 1996
Y1 - 1996
N2 - Purposes: To evaluate submacular surgery for the management of subfoveal choroidal neovascularization in punctate inner choroidopathy, to describe the histopathology and ultrastructure of the excised subretinal tissue, and to propose a staging system that characterizes the development of choroidal neovascularization with associated subretinal fibrosis. Methods: The authors reviewed the records of five patients (6 eyes) with punctate inner choroidopathy who underwent submacular surgery for subfoveal choroidal neovascularization. Surgical specimens were examined using light and transmission electron microscopy. Results: Visual improvement was noted postoperatively in all six eyes, with follow-up ranging from 8 to 36 months (median, 14 months). Recurrences (6 in 4 eyes) were common. Five of the six recurrences required additional procedures: three were managed surgically, two with laser photocoagulation, and one with observation. 'Bridging' of separate foci of choroidal neovascularization resulted in stellate or 'dumbbell-shaped' areas of subretinal fibrosis in four of six eyes. Histopathologic evaluation of the excised tissue showed endothelial-lined vascular channels, retinal pigment epithelium, lymphocytes, plasma cells, fibrocytes, collagen fragments, and rarely, outer retinal elements. Conclusions: Subfoveal choroidal neovascularization in punctate inner choroidopathy may be managed with submacular surgery. Recurrences are common and may result in substantial loss of vision. Choroidal neovascular membranes with an accompanying fibrotic reaction are responsible for the stellate or dumbbell-shaped areas of subretinal fibrosis. No beneficial effect was demonstrated using corticosteroid treatment of the choroidal neovascularization.
AB - Purposes: To evaluate submacular surgery for the management of subfoveal choroidal neovascularization in punctate inner choroidopathy, to describe the histopathology and ultrastructure of the excised subretinal tissue, and to propose a staging system that characterizes the development of choroidal neovascularization with associated subretinal fibrosis. Methods: The authors reviewed the records of five patients (6 eyes) with punctate inner choroidopathy who underwent submacular surgery for subfoveal choroidal neovascularization. Surgical specimens were examined using light and transmission electron microscopy. Results: Visual improvement was noted postoperatively in all six eyes, with follow-up ranging from 8 to 36 months (median, 14 months). Recurrences (6 in 4 eyes) were common. Five of the six recurrences required additional procedures: three were managed surgically, two with laser photocoagulation, and one with observation. 'Bridging' of separate foci of choroidal neovascularization resulted in stellate or 'dumbbell-shaped' areas of subretinal fibrosis in four of six eyes. Histopathologic evaluation of the excised tissue showed endothelial-lined vascular channels, retinal pigment epithelium, lymphocytes, plasma cells, fibrocytes, collagen fragments, and rarely, outer retinal elements. Conclusions: Subfoveal choroidal neovascularization in punctate inner choroidopathy may be managed with submacular surgery. Recurrences are common and may result in substantial loss of vision. Choroidal neovascular membranes with an accompanying fibrotic reaction are responsible for the stellate or dumbbell-shaped areas of subretinal fibrosis. No beneficial effect was demonstrated using corticosteroid treatment of the choroidal neovascularization.
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U2 - 10.1016/S0161-6420(96)30387-4
DO - 10.1016/S0161-6420(96)30387-4
M3 - Article
C2 - 9003340
AN - SCOPUS:0030470153
SN - 0161-6420
VL - 103
SP - 2061
EP - 2069
JO - Ophthalmology
JF - Ophthalmology
IS - 12
ER -