Abstract
Choroidal neovascularization (CNV) presents with a variety of visual symptoms and signs that can serve as clues to the proper diagnosis [1–3]. The physical invasion of blood vessels and associated cellular infiltrate distorts retinal tissue. Associated leakage, bleeding, and eventual scarring can have profound effects on macular function. Recognition of the presence of CNV is fairly easy in advanced cases, but by then, there often is severe vision loss. CNV secondary to age-related macular degeneration (AMD) used to be the leading cause of legal blindness among older adults [4]. With modern treatments aimed against vascular endothelial growth factor (VEGF), the visual acuity in a large majority of patients can be stabilized over the long term, but visual acuity improvement occurs in a minority of patients [5, 6]. Therefore, early diagnosis, prior to the patient suffering severe loss of vision, is the best hope of maintaining visual function in these older adults.
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References
Fine SL, Berger JW, Maguire MG, Ho AC (2000) Age-related macular degeneration. N Engl J Med 342:483–492
Jager RD, Mieler WF, Miller JW (2008) Age-related macular degeneration. N Engl J Med 12(358):2606–2617
Fine AM, Elman MJ, Ebert JE, Prestia PA, Starr JS, Fine SL (1986) Earliest symptoms caused by neovascular membranes in the macula. Arch Ophthalmol 104:513–514
Kahn HA, Leibowitz HM, Ganley JP et al (1977) The Framingham Eye Study. I. Outline and major prevalence findings. Am J Epidemiol 106:17–32
Rosenfeld PJ, Brown DM, Heier JS et al (2006) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355:1419–1431
Brown DM, Kaiser PK, Michels M et al (2006) Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444
Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials – TAP report. Arch Ophthalmol 117:1329–1345
Yang SS, Fu AD, McDonald HR, Johnson RN, Ai E, Jumper JM (2003) Massive spontaneous choroidal hemorrhage. Retina 23:139–144
Lamoureux EL, Hassell JB, Keeffe JE (2004) The determinants of participation in activities of daily living in people with impaired vision. Am J Ophthalmol 137:265–270
Lee PP, Cunningham WE, Nakazono TT, Hays RD (2009) Associations of eye diseases and symptoms with self-reported physical and mental health. Am J Ophthalmol 148:804–808.e1
Brown GC, Sharma S, Brown MM, Kistler J (2000) Utility values and age-related macular degeneration. Arch Ophthalmol 118:47–51
Marmor MF (2000) A brief history of macular grids: from Thomas Reid to Edvard Munch and Marc Amsler. Surv Ophthalmol 44:343–353
Augustin AJ, Offermann I, Lutz J, Schmidt-Erfurth U, Tornambe P (2005) Comparison of the original Amsler grid with the modified Amsler grid. Results for patients with age-related macular degeneration. Retina 25:443–445
Wall M, May DR (1987) Threshold Amsler grid testing in maculopathies. Ophthalmology 94:1126–1133
Schuchard RA (1993) Validity and interpretation of Amsler grid reports. Arch Ophthalmol 111(6):776–780
Crossland M, Rubin G (2007) The Amsler chart: absence of evidence is not evidence of absence. Br J Ophthalmol 91:391–393
Loewenstein A, Malach R, Goldstein M et al (2003) Replacing the Amsler grid: a new method for monitoring patients with age-related macular degeneration. Ophthalmology 110:966–970
Coscas F, Coscas G, Souied E, Tick S, Soubrane G (2007) Optical coherence tomography identification of occult choroidal neovascularization in age-related macular degeneration. Am J Ophthalmol 144:592–599
Goldstein M, Loewenstein A, Barak A et al (2005) Results of a multicenter clinical trial to evaluate the preferential hyperacuity perimeter for detection of age-related macular degeneration. Retina 25:296–303
Achard OA, Safran AB, Duret FC, Ragama E (1995) Role of the completion phenomenon in the evaluation of Amsler grid results. Am J Ophthalmol 120(3):322–329
Alster Y, Bressler NM, Bressler SB et al (2005) Preferential Hyperacuity Perimeter (PreView PHP) for detecting choroidal neovascularization study. Ophthalmology 112:1758–1765
Fujii GY, De Juan E, Jr HMS, Sunness JS, Chang TS, Rossi JV (2003) Characteristics of visual loss by scanning laser ophthalmoscope microperimetry in eyes with subfoveal choroidal neovascularization secondary to age-related macular degeneration. Am J Ophthalmol 136:1067–1078
Gass JD, Agarwal A, Lavina AM, Tawansy KA (2003) Focal inner retinal hemorrhages in patients with drusen: an early sign of occult choroidal neovascularization and chorioretinal anastomosis. Retina 23:741–751
Tolentino MJ, Miller JW, Gragoudas ES et al (1996) Intravitreous injections of vascular endothelial growth factor produce retinal ischemia and microangiopathy in an adult primate. Ophthalmology 103:1820–1828
Grossniklaus HE, Gass JD (1998) Clinicopathologic correlations of surgically excised type 1 and type 2 submacular choroidal neovascular membranes. Am J Ophthalmol 126:59–69
Sawa M, Ober MD, Spaide RF (2006) Autofluorescence and retinal pigment epithelial atrophy after subretinal hemorrhage. Retina 26:119–120
Spaide RF, Goldbaum M, Wong DW, Tang KC, Iida T (2003) Serous detachment of the retina. Retina 23:820–846
Ting TD, Oh M, Cox TA, Meyer CH, Toth CA (2002) Decreased visual acuity associated with cystoid macular edema in neovascular age-related macular degeneration. Arch Ophthalmol 120:731–737
Spaide RF (2009) Enhanced depth imaging optical coherence tomography of retinal pigment epithelial detachment in age-related macular degeneration. Am J Ophthalmol 147:644–652
Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA (1995) Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina 15:100–110
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Spaide, R.F. (2013). Clinical Manifestations of Choroidal Neovascularization in AMD. In: Holz, F., Pauleikhoff, D., Spaide, R., Bird, A. (eds) Age-related Macular Degeneration. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-22107-1_7
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