Skip to main content
SpringerLink
Log in

Idiopathic sub-retinal neovascular membranes in the macula (hemorrhagic macular choroidopathy of young adults)

Clinical report and effectiveness of laser treatment

  • Published:
Documenta Ophthalmologica Aims and scope Submit manuscript

Abstract

Twenty-six patients with idiopathic sub-retinal neovascular membranes (INVMs) located within the posterior pole were examined. Clinical and fluorescein angiographic features of these patients are described. Follow-up ranged from 2 to 96 months (mean 16.5 months).

Laser treatment was performed according to the location of the neovascular membrane: 7 out of 9 eyes (77%) increased their final visual acuity or stabilized after Argon blue-green laser photocoagulation (INVMs further than 200 microns from the center of the fovea).

Krypton red light laser treatment was performed in 13 eyes with juxta-foveal and sub-foveal INVMs: following treatment 10 eyes (77%) improved by 2 or more Snellen lines or maintained their pre-treatment visual acuity.

Because of the fact that the Krypton laser was not yet available, 5 patients were not treated: all of them had sub-foveal (3) or juxta-foveal INVMs (2).

The natural history of 4 cases (80%) showed an increase in the final visual acuity in 3 eyes and a steady state in one eye. Pathogenesis and treatment outcome of the disease are finally discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gass JDM (1967) Pathogenesis of disciform detachment of the neuroepithelium. Amer J Ophthal 63:563–711

    Google Scholar 

  2. Gass JDM (1967) Pathogenesis of disciform detachment of the neuroepithelium V: Disciform macular degeneration secondary to focal choroiditis. Amer J Ophthal 63:661–687

    Google Scholar 

  3. Gass JDM (1970) Stereoscopic atlas of macular diseases. Saint-Louis, CV Mosby

    Google Scholar 

  4. Chisholm IH, Gass JDM and Hutton WL (1976) Late stage of serpiginous (geographic) choroiditis. Amer J Ophthal 82:343–351

    Google Scholar 

  5. Jampol LM, Orth DH, Daisy MJ and Rabb MF (1979) Subretinal neovascularization with geographic (serpiginous) choroiditis. Amer J Ophthal 88: 683–689

    Google Scholar 

  6. Fine SL, Owens Sl, Haller JA, Knox DL and Patz A (1981) Choroidal neovascularization as a late complication of ocular toxoplasmosis. Amer J Ophthal 91:318–322

    Google Scholar 

  7. Cothar AM and Friedman AH (1982) Subretinal neovascularization in ocular toxoplasmosis. Brit J Ophthal 66:524–529

    Google Scholar 

  8. Laatikainen L and Erkkila H (1982) Subretinal neovascularization in serpiginous choroiditis. Brit J Ophthal 66: 326–331

    Google Scholar 

  9. Blumenkranz MS and Gass JDM (1982) A typical serpiginous choroiditis. Arch Ophthal 100:1773–1775

    Google Scholar 

  10. Gass JDM (1967) Pathogenesis of disciform detachment of the neuroepithelium. IV: Disciform detachment secondary to heredodegenerative, neoplastic and traumatic lesions of the choroid. Amer J Ophthal 63:689–711

    Google Scholar 

  11. Waltmann DD, Gitter KA, Yannuzzi L and Shatz H (1978) Choroidal neovascularization associated with choroidal nevi. Amer J Ophthal 85:704–710

    Google Scholar 

  12. Snip RC, Green WR and Jaegers KR (1979) Choroidal nevus with sub-retinal pigment epithelial neovascular membrane and a positive P32 test. Ophthalmic Surg 3:33–42

    Google Scholar 

  13. Fuller B and Gitter KA (1973) Traumatic choroidal rupture with late serous detachment of the macula. Arch Ophthal 89:354–357

    Google Scholar 

  14. Smith RE, Kelley JS and Harbin TS (1974) Late macular complications of choroidal ruptures. Amer J Ophthal 77:650–658

    Google Scholar 

  15. Watzke RC, Packer AJ, Folk JC and Benson WE (1984) Punctate inner choroidopathy. Amer J Ophthal 98:572–584

    Google Scholar 

  16. Soubrane G, Binaghi M, Amalric P and Coscas G (1983) Birdshot retinochoroidopathy and sub-retinal neovascularization. Brit J Ophthal 67:461–467

    Google Scholar 

  17. Brucker AJ and Deglin EA (1985) Sub-retinal choroidal neovascularization in birdshot retinochoroidopathy. Amer J Ophthal 99:40–44

    Google Scholar 

  18. Klein R, Lewis RA and Meyers SM (1978) Sub-retinal neovascularization associated with fundus flavimaculatus. Arch Ophthal 96:2054–2057

    Google Scholar 

  19. Noble KG, Scher BM and Carr RE (1978) Polymorphus presentations in vitelliform macular dystrophy: Sub-retinal neovascularization and central choroidal atrophy. Brit J Ophthal 62:561–570

    Google Scholar 

  20. François J, De Laey JJ, Cambie E, Haussens M and Victoria-Troncoso V (1975) Neovascularization after Argon-laser photocoagulation of macular lesions. Amer J Ophthal 79:206–210

    Google Scholar 

  21. Fine SL, Patz A, Orth DH, Klein MJ, Finkelstein D and Yassur Y (1976) Sub-retinal neovascularization developing after prophilactic Argon-laser photocoagulation of atrophic macular scars. Amer J Ophthal 82:352–357

    Google Scholar 

  22. Deutman AF Significance of alteration of the outer blood-retinal barrier. In: The Blood-retinal Barriers, ed: Jose G Cunha-Vaz. New York, Plenum Publ.

  23. Klien BA (1965) Symposium macular disease: Clinical manifestations. 2. The macular lesion in angioid streaks (Groenblad-Strandberg syndrome). Trans Amer Acad Ophthal Otolaryn 69:620–622

    Google Scholar 

  24. Deutman AF and Kovacs B (1979) Argon laser treatment in complications of angioid streaks. Amer J Ophthal 88:12–17

    Google Scholar 

  25. Gerde LS (1974) Angioid streak in sickle cell trait hemoglobinopathy. Amer J Ophthal 77:462–464

    Google Scholar 

  26. Nagmal KS, Asdourian G, Goldbaum M and Goldberg M (1976) Angioid streaks and sickle-cell hemoglobinopathies. Brit J Ophthal 60:31–34

    Google Scholar 

  27. Condon Pi and Jampol LM (1981) Choroidal neovascularization induced by photocoagulation in sickle-cell disease. Brit J Ophthal 65:192–197

    Google Scholar 

  28. Gass JDM and Clarkson JG (1973) Angioid streaks and disciform macular detachment in Paget's disease (osteitis deformans). Amer J Ophthal 75:576–586

    Google Scholar 

  29. Deutman AF and Grizzard WS (1978) Rubella retinopathy and sub-retinal neovascularization. Amer J Ophthal 85:82–87

    Google Scholar 

  30. Frank KE and Purnell EW (1978) Sub-retinal neovascularization following rubella retinopathy. Amer J Ophthal 86:462–466

    Google Scholar 

  31. Orth DH, Fishmann GA, Segall M, Bhatt A and Yassur Y (1980) Rubella maculopathy. Brit J Ophthal 64:201–205

    Google Scholar 

  32. Michelson JB (1980) Sub-retinal neovascular membrane and disciform scar in Behcet's disease. Amer J Ophthal 90:182–185

    Google Scholar 

  33. Carlson MR (1977) Hemorrhagic macular detachment in Vogt-Koyanagi-Harada Syndrome. Amer J Ophthal 84: 632–635

    Google Scholar 

  34. Hoogstede Half and Copper AC (1982) A case of macular sub-retinal neovascularization in chronic uveitis, probably caused by Sarcoidosi. Brit J Ophthal 66: 530–535

    Google Scholar 

  35. Krill AE and Archer D (1970) Choroidal neovascularization in multifocal (presumed histoplasmin) choroiditis. Arch Ophthal 84:595–604

    Google Scholar 

  36. Schlaegel TF and Weber JC (1971) Follow-up study of presumed histoplasmic choroiditis. Amer J Ophthal 71:1192–1195

    Google Scholar 

  37. Gass JDM and Wilkinson CP (1972) Follow-up study of presumed ocular histoplasmosis. Trans Amer Acad Ophthal Otolaryn 76:672–694

    Google Scholar 

  38. Schlaegel TF (1974) Histoplasmic choroiditis. Ann Ophthal 6:237–252

    Google Scholar 

  39. Lewis ML and Gass JDM (1980) Follow-up study of presumed ocular histoplasmosis. Ophthalmology 87:390–399

    Google Scholar 

  40. François J, De Laey JJ and Dakir M (1974) Choroidopathie maculaire hémorragique chez les sujets jeunes. Bull Soc Belge Ophtal 167:664–678

    Google Scholar 

  41. Cleasby GW (1976) Idiopathic focal sub-retinal neovascularization. Amer J Ophthal 81:590–596

    Google Scholar 

  42. Schildberg P, Wessing A and Eller B (1975) Histoplasminhauttest bei fokaler hämorrhagischer Choroiditis. Klin Mbl Augenheilk 166:236–241

    Google Scholar 

  43. Braunstein RA, Rosen A and Bird AC (1975) Ocular histoplasmosis syndrome in the United Kingdom. Brit J Ophthal 58:893–898

    Google Scholar 

  44. Notting JGA, Deutman AF and Van Der Werf PJP (1975) Erscheinungsbild und Behandlung makulärer Läsionen bei multifokaler Choroiditis (presumed histoplasmosis). Klin Mbl Augenheilk 166:629–636

    Google Scholar 

  45. Craandijk A (1979) Focal Macular Choroidopathy. The Hague, Junk

    Google Scholar 

  46. Saraux H, Lefrançois A and Offret H (1979) La choroidopathie maculaire hémorragique du sujet jeune ou pseudohistoplasmose. J Fr Ophtal 2:349–354

    Google Scholar 

  47. Bonnet M, Dubost-Perret P and Grange JD (1981) Etude de 29 case de neovaisseaux chorodiens idiopathiques du sujet jeune (syndrome de pseudohistoplasmose) suivis depui 6 mois a 11 ans. Bull Soc Fr Ophtal 11: 1059–1061

    Google Scholar 

  48. Harstad HK and Guldsten H (1983) Focal macular choroidopathy. Acta Ophthal 61:1067–1073

    Google Scholar 

  49. Soubrane G, Koenig F and Coscas G (1983) Choroidopathie maculaire hémorragique du sujet jeun. J. Fr Ophtal 6:24–34

    Google Scholar 

  50. Macular Photocoagulation Study Group (1983) Argon laser photocoagulation for idiopathic neovascularization. Results of a randomized clinical trial. Arch Ophthal 101:1358–1361

    Google Scholar 

  51. Smith RE, Dunn S and Jester JV (1984) Natural history of experimental histoplasmic choroiditis in the primate. Clinical features. Inves Ophthal Vis Sci 25:801–809

    Google Scholar 

  52. Macular Photocoagulation Study (1983) Manual of Procedures, Chapter 11, Baltimore, MPS Coordinating Center

    Google Scholar 

  53. François J and Cambie E (1971) Retinal photocoagulation (xenon arc and lasers). Ann Ophthal 3:1201–1208

    Google Scholar 

  54. Marshall J, Hamilton AM and Bird AC (1974) Intraretinal absorption of argon laser irradiation in human and monkey retinae. Experientia 30:1335–1337

    Google Scholar 

  55. Marshall J and Bird AC (1979) A comparative histopathological study of argon and krypton laser irradiations of the human retina. Brit J Ophthal 63:657–668

    Google Scholar 

  56. Peyman GA, Li M and Shin Y (1981) Fundus photocoagulation with the argon and krypton lasers: A comparative study. Ophthalmic Surg 12:481–490

    Google Scholar 

  57. Yannuzzi LA (1982) Krypton red laser photocoagulation for sub-retinal neovascularization. Retina 2:29–46

    Google Scholar 

  58. Smith RE, Dunn S and Jester JV (1984) Natural history of experimental histoplasmic choroiditis in the primate. Clinical features. Inves Ophthal Vis Sci 25:801–809

    Google Scholar 

  59. Macular Photocoagulation Study (1983) Manual of Procedures, Chapter 11, Baltimore, MPS Coordinating Center

    Google Scholar 

  60. François J and Cambie E (1971) Retinal photocoagulation (xenon arc and lasers). Ann Ophthal 3:1201–1208

    Google Scholar 

  61. Marshall J, Hamilton AM and Bird AC (1974) Intraretinal absorption of argon laser irradiation in human and monkey retinae. Experientia 30:1335–1337

    Google Scholar 

  62. Marshall J and Bird AC (1979) A comparative histopathological study of argon and krypton laser irradiations of the human retina. Brit J Ophthal 63:657–668

    Google Scholar 

  63. Peyman GA, Li M and Shin Y (1981) Fundus photocoagulation with the argon and krypton lasers: A comparative study. Ophthalmic Surg 12:481–490

    Google Scholar 

  64. Yannuzzi LA (1982) Krypton red laser photocoagulation for sub-retinal neovascularization. Retina 2:29–46

    Google Scholar 

  65. L'Esperance FAJ (1983) Ophthalmic Lasers. St. Louis, CV Mosby

    Google Scholar 

  66. Hayreh SS (1975) Segmental nature of the choroidal vasculature. Brit J Ophthal 59:631–648

    Google Scholar 

  67. Hayreh SS (1974) Submacular choroidal vascular pattern. Graefe's Arch Klin Exp Ophthal 192:181–196

    Google Scholar 

  68. Hayreh SS (1981) Controversies on submacular choroidal circulation. Ophthalmologica 183:11–19

    Google Scholar 

  69. Hayreh SS (1983) Macular lesions secondary to choroidal vascular disorders. Int Ophthal 6:161–170

    Google Scholar 

  70. Ring HG and Fujino T (1967) Observations on the anatomy and pathology of the choroidal vasculature. Arch Ophthal 78:431–444

    Google Scholar 

  71. Shimizu K (1978) Segmental nature of angioarchitecture of the choroid. Acta XXIII Conc Ophthal, Kyoto, pp 215–219

  72. Matsuo N (1980) Studies on choroidal circulation. Acta Soc Ophthal Jap 84:2147–2206

    Google Scholar 

  73. Deutman AF and Lion F (1977) Choriocapillaris non perfusion in acute multifocal placoid pigment epitheliopathy. Amer J Ophthal 84:652–657

    Google Scholar 

  74. Wright BE, Bird AC and Hamilton AM (1978) Placoid pigment epitheliopathy and Harada's disease. Brit J Ophthal 62:609–621

    Google Scholar 

  75. Deutman AF (1980) Choriocapillaris filling patterns in health and disease. Trans Ophthal Soc UK 100:553–558

    Google Scholar 

  76. Hayreh SS (1980) Acute choroidal ischemia. Trans Ophthal Soc UK 100:400–407

    Google Scholar 

  77. Young NJA, Bird AC and Sehmi K (1980) Pigment epithelial diseases with abnormal choroidal perfusion. Amer J Ophthal 90:607–618

    Google Scholar 

  78. Deutman AF (1983) Acute multifocal ischaemic choroidopathy and the choriocapillaris. Int Ophthal 6:155–160

    Google Scholar 

  79. Krill AE, Chishti MI and Klien BA et al. (1969) Multifocal inner choroiditis. Trans Amer Acad Ophthal Otolaryn 73:222–242

    Google Scholar 

  80. Okun E (1972) Photocoagulation treatment of POHS. Trans Amer Acad Ophthal Soc 70:467–489

    Google Scholar 

  81. Elliott JH and Jackson DJ (1975) Presumed histoplasmic maculopathy: Clinical course and prognosis in nonphotocoagulated eyes. Int Ophthal Clin 15:29–39

    Google Scholar 

  82. Klein ML, Fine SL, Knox DL and Patz A (1977) Follow up study in eyes with choroidal neovascularization caused by POHS. Amer J Ophthal 83:830–835

    Google Scholar 

  83. Gutman FA (1979) The natural course of active choroidal lesions in the presumed ocular histoplasmosis syndrome. Trans Amer Ophthal Soc 77:515–541

    Google Scholar 

  84. Olk J, Burgess DB and McCornick PA (1984) Subfoveal and iuxtafoveal sub-retinal neovascularization in the presumed ocular histoplasmosis syndrome. Ophthalmology 91:1592–1602

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Eye Clinic, St. Paolo Hospital, Via A. di Rudini, 8, I-20142, Milan, Italy

    F. G. Bottoni

  2. Institute of Ophthalmology, University of Nijmegen, Philips Van Leydenlaan 15, 6525, EX Nijmegen, the Netherlands

    A. F. Deutman

Authors
  1. F. G. Bottoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. F. Deutman
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bottoni, F.G., Deutman, A.F. Idiopathic sub-retinal neovascular membranes in the macula (hemorrhagic macular choroidopathy of young adults). Doc Ophthalmol 64, 311–343 (1987). https://doi.org/10.1007/BF00161734

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00161734

Key words

Search

Navigation