Subretinal surgery for peripapillary subretinal neovascular membranes.
OBJECTIVE
To report the results of surgical removal of extrafoveal peripapillary subretinal neovascular membranes (PSRNVMs) for elderly patients in whom visual acuity was threatened or affected by subretinal fluid, subretinal hemorrhage, subretinal exudate, or PSRNVM growth toward the fovea.


METHODS
Retrospective review of six eyes of six patients undergoing subretinal surgical removal of PSRNVMs via pars plana vitrectomy.


RESULTS
PSRNVMs were successfully removed in six eyes of six patients with initial preservation of foveal function. The preoperative Snellen visual acuity ranged from 20/40 to counting fingers, and the best postoperative visual acuity ranged from 20/25 to 20/40. The final visual acuity with a mean follow-up of 3 years (range, 6-63 months) was stable or improved in 83% (5 eyes) of cases, ranging from 20/25 to 20/80. Early recurrence of PSRNVM was noted only in 1 eye (17%) at 1 month after surgery and was successfully treated with laser photocoagulation. Late recurrence of choroidal neovascularization developed after 3 years in two eyes. Cataract developed in three of four phakic eyes.


CONCLUSIONS
PSRNVMs sparing the central fovea in elderly patients can be successfully removed surgically with initial preservation of foveal function and with a low rate of early recurrence.
Kokame
Gregg T
GT
Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, Hawaii, USA.
Yamaoka
Seijo
S
Yamamoka
Seijo
S
D000368:Aged; D000369:Aged, 80 and over; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk; D012160:Retina / Q000601:surgery*; D012166:Retinal Hemorrhage / Q000601:surgery; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy