The Swedish national survey of surgical excision for submacular choroidal neovascularization (CNV).
OBJECTIVE
To compare the visual outcome after surgical removal of subfoveal choroidal neovascularization (CNV) in patients younger and older than 50 years of age.


METHODS
Patient records from all Swedish centers performing submacular CNV surgery were reviewed and 90 patients treated between 1992-1999 with a follow-up of 6 months or more were included. The results obtained in 49 patients aged 51-89 years (median=72 years) with neovascular disease caused by age-related macular degeneration (AMD) were compared with the outcome of 41 patients aged 6-49 years (median=36 years) with CNV secondary to non-AMD causes. The main outcome measure was the improvement or deterioration in visual acuity (standardized in logMAR units) at 6 months following surgery. Secondary endpoints were recurrent CNV and surgical complications.


RESULTS
The level of preoperative visual acuity was not significantly different between younger patients with CNV associated with non-AMD and older patients with visual loss due to AMD (p=0.069). However, visual acuity at 6 months after surgery was better (p=0.0042) in younger patients (median improvement=0.19 logMAR) than in older patients (median improvement=0.0 log MAR). Marked visual improvement (>1 log MAR unit) was seen in 29% of non-AMD patients <50 years compared to 0% in the AMD group >50 years.


CONCLUSIONS
Surgical removal of submacular CNV does not appear to improve visual acuity in patients > 50 years of age. However, it may be beneficial for younger patients where a substantial improvement of visual acuity is seen in a subset of these patients. Further studies are required to assess the long-term outcome.
Berglin
L
L
Department of Retina and Oncology, St. Eriks Eye Hospital, Polhemsgatan 50, S-112 82 Stockholm, Sweden. lennart.berglin@sankterik.se
Algvere
P
P
Olivestedt
G
G
Crafoord
S
S
Stenkula
S
S
Hansson
L J
LJ
Tomic
Z
Z
Kvanta
A
A
Seregard
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002648:Child; D020256:Choroidal Neovascularization / Q000209:etiology / Q000601:surgery*; D006306:Health Surveys; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D008875:Middle Aged; D012008:Recurrence; D013548:Sweden; D014792:Visual Acuity