Characteristics and outcomes of choroidal neovascularization occurring after macular hole surgery.
OBJECTIVE
To study the characteristics and outcomes of choroidal neovascularization (CNV) developing after surgery for idiopathic macular holes.


METHODS
Retrospective, noncomparative case series. Search of diagnostic and procedure databases of four participating institutes identified nine eyes of eight patients with CNV after surgery for idiopathic macular hole. Demographic, clinical, and fundus fluorescein angiographic data were abstracted from patients' medical records.


RESULTS
Choroidal neovascularization developed 6 weeks to 30 months after macular hole surgery. The macular hole was closed in all cases. The CNV complex involved the foveal region in 9 (100%) eyes, was predominantly classic in 8 (89%) eyes, and was associated with moderate to severe leakage of fluorescein in 8 (89%) eyes. The CNV was crescent-shaped and spared the central area of retinal pigment epithelial mottling that corresponded to the site of the macular hole in 6 (67%) cases. Other fluorescein angiographic features included retinal pigment epitheliopathy in 6 (67%) eyes and presence of drusen in 7 (78%) eyes. The final visual acuity after a mean follow-up period of 11.2 months (range, 3-16 months) was 20/50 to 20/80 in 2 (22%) eyes, 20/100 to 20/200 in 1 (11%) eye, and less than 20/200 in 6 (67%) eyes.


CONCLUSIONS
Choroidal neovascular complexes occurring after macular hole surgery tend to share certain characteristics, including foveal involvement, frequent sparing of the central area corresponding to the site of the closed macular hole, and generally poor visual outcomes. Therapeutic modalities including photodynamic therapy and surgical options may be considered in these patients.
Tabandeh
Homayoun
H
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA.
Smiddy
William E
WE
Sullivan
Paul M
PM
Monshizadeh
Ramin
R
Rafiei
Nastaran
N
Cheng
Lingyun
L
Freeman
William
W
D000368:Aged; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000209:etiology*; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016684:Prone Position; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren