Chorioretinal damage caused by the excision of choroidal neovascularization.
OBJECTIVE
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.


CONCLUSIONS
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.
Tsujikawa
M
M
Department of Ophthalmology, Osaka University Medical School, Japan.
Sawa
M
M
Lewis
J M
JM
Motokura
M
M
Tsujikawa
K
K
Ohji
M
M
Saito
Y
Y
Tano
Y
Y
D000328:Adult; D000368:Aged; D002829:Choroid / Q000098:blood supply* / Q000293:injuries* / Q000473:pathology; D015862:Choroid Diseases / Q000209:etiology* / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D007431:Intraoperative Complications; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D012160:Retina / Q000293:injuries* / Q000473:pathology; D012164:Retinal Diseases / Q000209:etiology* / Q000473:pathology; D014792:Visual Acuity
D007208:Indocyanine Green