[Photocoagulation of the retinal feeder vessels of a chorioretinal anastomosis in age-related macular degeneration].
The presence of a chorioretinal anastomosis in the setting of age-related macular degeneration is known as a sign of poor prognosis. No treatment has proven to be effective. We describe a 71-year-old female patient presenting with exudative age-related macular degeneration, a chorioretinal anastomosis with two retinal feeder vessels (arteriole and veinule), a serous retinal pigment epithelium detachment, and a suspected early subretinal neovascular membrane. She was treated with ICG-guided laser photocoagulation directed to the hot spot, with treatment-zone enlargement directed to the retinal feeder vessels and followed up for 6 months. Although a second laser treatment for the reperfused subretinal neovascular membrane was needed, the clinical and angiographic end result was beneficial. Visual acuity improved by two lines, the chorioretinal anastomosis was occluded, and the pigment epithelium reattached. Taking into account the low therapeutic success rate described in the literature, we suggest that the specific treatment of the retinal feeder vessels, which to our knowledge has not been described before, may be a valuable treatment option.
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Hôpital Ophtalmique Jules Gonin, Lausanne, University of Lausanne, 15, avenue de France, 1004 Lausanne, Suisse.
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D000368:Aged; D000375:Aging / Q000502:physiology*; D000714:Anastomosis, Surgical; D002823:Chorion / Q000601:surgery*; D005260:Female; D006801:Humans; D008028:Light Coagulation; D008268:Macular Degeneration / Q000601:surgery*; D012160:Retina / Q000601:surgery*; D012171:Retinal Vessels / Q000601:surgery*