title: Surgical removal of peripapillary choroidal neovascularization associated with age-related macular degeneration.
abstract: OBJECTIVE
  To describe the results of surgical treatment of peripapillary choroidal neovascularization in age-related macular degeneration as an option to both laser photocoagulation and photodynamic therapy.
  
  
  METHODS
  Retrospective review of patients with peripapillary choroidal neovascularization secondary to age-related macular degeneration who were not eligible for or refused laser photocoagulation. Patients without the diagnosis of age-related macular degeneration and those who had extension of their neovascularization subfoveally were excluded from the review.
  
  
  RESULTS
  Eleven patients total were identified who met the specified inclusion criteria. The male to female ratio was 4:7, with an age range of 63 to 94 years (mean = 78 years). The mean area of involved retina temporal to the optic disc was 5 clock hours, with the distance of the temporal edge of the lesion from the fovea ranging from 100 to 2,000 microm. The mean duration of follow-up was 23 months, with 27% (3 of 11) experiencing recurrent choroidal neovascularization. The preoperative and postoperative visual acuity ranges were both 20/25 to counting fingers. Sixty-four percent (7 of 11) of patients had stable or improved visual acuity postoperatively, with a mean visual acuity change of 1 line visual improvement.
  
  
  CONCLUSIONS
  In cases where photodynamic therapy and laser photocoagulation are not indicated, the surgical treatment of peripapillary choroidal neovascularization secondary to age-related macular degeneration may prove beneficial.
authors.affiliation: Barnes Retina Institute, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Blinder
authors.forename: Gaurav K
authors.initials: GK
authors.lastname: Shah
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Thomas
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Holekamp
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Joseph
authors.forename: M Gilbert
authors.initials: MG
authors.lastname: Grand
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008268:Macular Degeneration / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009898:Optic Disk; D012189:Retrospective Studies; D014792:Visual Acuity