Angiographic characteristics in patients undergoing macular translocation for subfoveal choroidal neovascularization secondary to age-related macular degeneration.
OBJECTIVE
To review in a standardized fashion pre- and postoperative fluorescein angiographic characteristics in patients undergoing limited macular translocation (LMT) with scleral imbrication to treat subfoveal choroidal neovascularization (SFCNV) secondary to age-related macular degeneration (AMD). The current study was undertaken to assess any potential effects of the translocation procedure on altering the angiographic characteristics of SFCNV before laser photocoagulation.


METHODS
A consecutive series of patients undergoing LMT for AMD was identified retrospectively. The pre- and postoperative fluorescein angiograms were reviewed in a masked fashion. Angiographic characteristics evaluated included pre- and postoperative lesion components, stability of lesion, and the amount of retinal translocation obtained.


RESULTS
Eighty-eight patients (90 eyes) had angiograms of adequate quality to permit evaluation. Time between the preoperative and the prelaser angiogram ranged from 2 to 84 days (median 7.5 days). Neovascular complexes remained unchanged or decreased in size in 79% of patients. There was no statistically significant difference in lesion size between the pre- and postoperative periods (P = 0.34). Retinal movement ranged from 160 microm to 3,320 microm (median 960 microm), with 61% of cases undergoing effective translocation (i.e., the fovea was moved away from the neovascular complex). None of the lesion components or demographic factors evaluated affected the amount of translocation obtained. Larger lesions were more likely to remain subfoveal following translocation (P = 0.004).


CONCLUSIONS
The size and lesion characteristics appear relatively stable following translocation. Amount of retinal movement is not associated with angiographic lesion characteristics. Only size was associated with achievement of desired translocation in the final model, with large lesions being less likely to achieve desired translocation. In our study group, the amount of retinal translocation was variable with 61% of cases undergoing effective translocation.
Kent
David L
DL
Vitreoretinal Service, Wilmer Institute, Johns Hopkins University, Baltimore, Maryland, USA.
Fujii
Gildo Y
GY
Pieramici
Dante J
DJ
Reynolds
Sandra M
SM
Melia
Michele
M
Rossi
Juliana V
JV
Humayun
Mark S
MS
Caffey
Sean
S
De Juan
Eugene
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016342:Angioplasty, Laser / Q000379:methods; D020256:Choroidal Neovascularization / Q000473:pathology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D008266:Macula Lutea / Q000637:transplantation*; D008268:Macular Degeneration / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis; D011859:Radiography; D012160:Retina / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013997:Time Factors