The natural history of idiopathic subfoveal choroidal neovascularization.
OBJECTIVE
To study the long-term natural history of idiopathic subfoveal choroidal neovascularization (CNV) in young patients.


METHODS
A retrospective survey of 19 consecutive patients with idiopathic subfoveal CNV diagnosed in an urban eye hospital and a single practice.


RESULTS
Twenty-three (26%) of 87 consecutive patients with idiopathic CNV demonstrated subfoveal CNV. Nineteen patients with subfoveal involvement were followed for a median of 87 months (range, 5-230 months). On initial examination, the median best-corrected Snellen visual acuity was 20/100 (range, 20/40-counting fingers); at final examination, the median visual acuity was 20/70 (range, 20/20-counting fingers). A total of 95% of patients had stable or significantly improved visual acuity, whereas only 5% had significant visual loss. Size of the CNV was the only variable associated with long-term final visual acuity. Lesions 1 disc area or smaller at the time of initial fluorescein angiography were more likely to be associated with a final visual acuity of 20/60 or better and less likely to be associated with a final visual acuity of 20/200 or worse (P = 0.038) as compared with larger lesions. These results were confirmed with multiple logistic regression analysis (P = 0.027). Fellow eyes remained unaffected during the follow-up period.


CONCLUSIONS
The natural history of idiopathic subfoveal CNV is not necessarily associated with a profound loss of vision. Therapies for this type of subfoveal lesion must take into consideration the possibility of a favorable natural course.
Ho
A C
AC
Vitreoretinal Service, University of Pennsylvania, Scheie Eye Institute 19104, USA.
Yannuzzi
L A
LA
Pisicano
K
K
DeRosa
J
J
D000328:Adult; D002829:Choroid / Q000098:blood supply* / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D014792:Visual Acuity