Skip to main content

Choroidal Neovascular Membrane

  • Chapter
  • First Online:
Vitreoretinal Surgery
  • 1472 Accesses

Abstract

Choroidal neovascular membranes (CNVs) most commonly occur with age-related macular degeneration (ARMD). Features of ‘dry’ AMD include hard drusen, soft drusen, ­retinal pigment epithelial disruption and geographic atrophy. Patients with extensive small drusen, non-extensive intermediate size drusen or pigment abnormalities have only a 1.3 % 5-year probability of progression to advanced AMD according to the ARED Study (Age-Related Eye Disease Study Research Group 2001). Those with extensive intermediate size drusen, at least one large druse, noncentral geographic atrophy in one or both eyes, or advanced AMD or vision loss due to AMD in one eye, are at risk of vision loss from advanced AMD in up to 50 % (large drusen with pigmentary changes) after 5 years (Ferris et al. 2005).

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Age-Related Eye Disease Study Research Group (2001) A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol 119(10):1417–1436

    Article  Google Scholar 

  • Aisenbrey S, Lafaut BA, Szurman P, Grisanti S, Luke C, Krott R, Thumann G, Fricke J, Neugebauer A, Hilgers RD, Esser P, Walter P, Bartz-Schmidt KU (2002) Macular translocation with 360 degrees retinotomy for exudative age-related macular degeneration. Arch Ophthalmol 120(4):451–459

    Article  PubMed  Google Scholar 

  • Angunawela RI, Williamson TH, Khan MA, Chong V (2005) Choroidal translocation with a pedicle following excision of a type 1 choroidal neovascular membrane. Br J Ophthalmol 89(3):386

    Article  PubMed  CAS  Google Scholar 

  • Atebara NH, Thomas MA, Holekamp NM, Mandell BA, Del Priore LV (1998) Surgical removal of extensive peripapillary choroidal neovascularization associated with presumed ocular histoplasmosis syndrome. Ophthalmology 105(9):1598–1605

    Article  PubMed  CAS  Google Scholar 

  • Avery RL, Pieramici DJ, Rabena MD, Castellarin AA, Nasir MA, Giust MJ (2006) Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmology 113(3):363–372

    Article  PubMed  Google Scholar 

  • Bains HS, Patel MR, Singh H, Marcus DM (2003) Surgical treatment of extensive peripapillary choroidal neovascularization in elderly patients. Retina 23(4):469–474

    Article  PubMed  Google Scholar 

  • bdel-Meguid A, Lappas A, Hartmann K, Auer F, Schrage N, Thumann G, Kirchhof B (2003) One year follow up of macular translocation with 360 degree retinotomy in patients with age related macular degeneration. Br J Ophthalmol 87(5):615–621

    Article  Google Scholar 

  • Berger AS, McCuen BW, Brown GC, Brownlow RL Jr (1997) Surgical removal of subfoveal neovascularization in idiopathic juxtafoveolar retinal telangiectasis. Retina 17(2):94–98

    Article  PubMed  CAS  Google Scholar 

  • Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S (2006) Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 355(14):1432–1444. doi:355/14/1432, [pii] 10.1056/NEJMoa062655

    Article  PubMed  CAS  Google Scholar 

  • Cahill MT, Stinnett SS, Banks AD, Freedman SF, Toth CA (2005) Quality of life after macular translocation with 360 degrees peripheral ­retinectomy for age-related macular degeneration. Ophthalmology 112(1):144–151

    Article  PubMed  Google Scholar 

  • Chakravarthy U, Adamis AP, Cunningham ET Jr, Goldbaum M, Guyer DR, Katz B, Patel M (2006) Year 2 efficacy results of 2 randomized controlled clinical trials of pegaptanib for neovascular age-related macular degeneration. Ophthalmology 113(9):1508–1525

    PubMed  Google Scholar 

  • Cooper BA, Thomas MA (2000) Submacular surgery to remove choroidal neovascularization associated with central serous chorioretinopathy. Am J Ophthalmol 130(2):187–191

    Article  PubMed  CAS  Google Scholar 

  • Eckardt C, Eckardt U, Conrad HG (1999) Macular rotation with and without counter-rotation of the globe in patients with age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 237(4):313–325

    Article  PubMed  CAS  Google Scholar 

  • Ferris FL, Davis MD, Clemons TE, Lee LY, Chew EY, Lindblad AS, Milton RC, Bressler SB, Klein R (2005) A simplified severity scale for age-related macular degeneration: AREDS report no. 18. Arch Ophthalmol 123(11):1570–1574. doi:123/11/1570, [pii] 10.1001/archopht.123.11.1570

    Article  PubMed  Google Scholar 

  • Fujii GY, De Juan E, Humayun MS Jr, Chang TS (2003) Limited macular translocation for the management of subfoveal choroidal neovascularization after photodynamic therapy. Am J Ophthalmol 135(1):109–112

    Article  PubMed  Google Scholar 

  • Fujikado T, Asonuma S, Ohji M, Kusaka S, Hayashi A, Ikuno Y, Kamei M, Oda K, Tano Y (2002) Reading ability after macular translocation surgery with 360-degree retinotomy. Am J Ophthalmol 134(6):849–856

    Article  PubMed  Google Scholar 

  • Gopalakrishan M, Giridhar A, Bhat S, Saikumar SJ, Elias A, N S (2007) Pneumatic displacement of submacular hemorrhage: safety, efficacy, and patient selection. Retina 27 (3):329–334. doi: 10.1097/01.iae.0000231544.43093.40 00006982-200703000-00008 [pii]

    Google Scholar 

  • Gross JG, King LP, De Juan E Jr, Powers T (1996) Subfoveal neovascular membrane removal in patients with traumatic choroidal rupture. Ophthalmology 103(4):579–585

    PubMed  CAS  Google Scholar 

  • Grossniklaus HE, Wilson DJ, Bressler SB, Bressler NM, Toth CA, Green WR, Miskala P (2006) Clinicopathologic studies of eyes that were obtained postmortem from four patients who were enrolled in the submacular surgery trials: SST report no. 16. Am J Ophthalmol 141(1):93–104. doi:S0002-9394(05)00878-0, [pii] 10.1016/j.ajo.2005.07.076

    Article  PubMed  Google Scholar 

  • Hawkins BS, Miskala PH, Bass EB, Bressler NM, Childs AL, Mangione CM, Marsh MJ (2004) Surgical removal vs. observation for subfoveal choroidal neovascularization, either associated with the ocular histoplasmosis syndrome or idiopathic: II. Quality-of-life findings from a randomized clinical trial: SST Group H Trial: SST report no. 10. Arch Ophthalmol 122(11):1616–1628

    Article  PubMed  Google Scholar 

  • Hesse L, Meitinger D, Schmidt J (1996) Little effect of tissue plasminogen activator in subretinal surgery for acute hemorrhage in age-related macular degeneration. Ger J Ophthalmol 5(6):479–483

    PubMed  CAS  Google Scholar 

  • Ichibe M, Yoshizawa T, Funaki S, Funaki H, Ozawa Y, Tanaka Y, Abe H (2002) Severe hypotony after macular translocation surgery with 360-degree retinotomy. Am J Ophthalmol 134(1):139–141

    Article  PubMed  Google Scholar 

  • Joussen AM, Heussen FM, Joeres S, Llacer H, Prinz B, Rohrschneider K, Maaijwee KJ, van Meurs J, Kirchhof B (2006) Autologous translocation of the choroid and retinal pigment epithelium in age-related macular degeneration. Am J Ophthalmol 142(1):17–30

    Article  PubMed  Google Scholar 

  • Khurana RN, Fujii GY, Walsh AC, Humayun MS, De Juan E Jr, Sadda SR (2005) Rapid recurrence of geographic atrophy after full macular translocation for nonexudative age-related macular degeneration. Ophthalmology 112(9):1586–1591

    Article  PubMed  Google Scholar 

  • Kuhli-Hattenbach C, Fischer IB, Schalnus R, Hattenbach LO (2010) Subretinal hemorrhages associated with age-related macular degeneration in patients receiving anticoagulation or antiplatelet therapy. Am J Ophthalmol 149(2):316–321.e3311. doi:S0002-9394(09)00659-X, [pii] 10.1016/j.ajo.2009.08.033

    Article  PubMed  CAS  Google Scholar 

  • Lai JC, Lapolice DJ, Stinnett SS, Meyer CH, Arieu LM, Keller MA, Toth CA (2002) Visual outcomes following macular translocation with 360-degree peripheral retinectomy. Arch Ophthalmol 120(10):1317–1324

    Article  PubMed  Google Scholar 

  • Lappas A, Foerster AM, Weinberger AW, Coburger S, Schrage NF, Kirchhof B (2004) Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration: long-term results. Graefes Arch Clin Exp Ophthalmol 242(8):638–647

    Article  PubMed  Google Scholar 

  • Lit ES, Kim RY, Damico DJ (2001) Surgical removal of subfoveal choroidal neovascularization without removal of posterior hyaloid: a consecutive series in younger patients. Retina 21(4):317–323

    Article  PubMed  CAS  Google Scholar 

  • Machemer R, Steinhorst UH (1993a) Retinal separation, retinotomy, and macular relocation: I. Experimental studies in the rabbit eye. Graefes Arch Clin Exp Ophthalmol 231(11):629–634

    Article  PubMed  CAS  Google Scholar 

  • Machemer R, Steinhorst UH (1993b) Retinal separation, retinotomy, and macular relocation: II. A surgical approach for age-related macular degeneration? Graefes Arch Clin Exp Ophthalmol 231(11):635–641

    Article  PubMed  CAS  Google Scholar 

  • Melberg NS, Thomas MA, Dickinson JD, Valluri S (1996) Managing recurrent neovascularization after subfoveal surgery in presumed ocular histoplasmosis syndrome. Ophthalmology 103(7):1064–1067

    PubMed  CAS  Google Scholar 

  • Mruthyunjaya P, Stinnett SS, Toth CA (2004) Change in visual function after macular translocation with 360 degrees retinectomy for ­neovascular age-related macular degeneration. Ophthalmology 111(9):1715–1724

    Article  PubMed  Google Scholar 

  • Ng EW, Bressler NM, Boyer DS, De Juan E Jr (2002) Iatrogenic choroidal neovascularization occurring in patients undergoing macular surgery. Retina 22(6):711–718

    Article  PubMed  Google Scholar 

  • Ohji M, Saito Y, Hayashi A, Lewis JM, Tano Y (1998) Pneumatic displacement of subretinal hemorrhage without tissue plasminogen activator. Arch Ophthalmol 116(10):1326–1332

    Article  PubMed  CAS  Google Scholar 

  • Orth DH, Flood TP (1982) Management of breakthrough vitreous hemorrhage from presumed extramacular subretinal neovascularization. Retina 2(2):89–93

    Article  PubMed  CAS  Google Scholar 

  • Oshima Y, Ohji M, Tano Y (2007) Pars plana vitrectomy with peripheral retinotomy after injection of preoperative intravitreal tissue plasminogen activator: a modified procedure to drain massive subretinal haemorrhage. Br J Ophthalmol 91(2):193–198. doi:bjo.2006.101444, [pii] 10.1136/bjo.2006.101444

    Article  PubMed  CAS  Google Scholar 

  • Pertile G, Claes C (2002) Macular translocation with 360 degree retinotomy for management of age-related macular degeneration with subfoveal choroidal neovascularization. Am J Ophthalmol 134(4):560–565

    Article  PubMed  Google Scholar 

  • Phillips SJ, Sadda SR, Tso MO, Humayan MS, De Juan E Jr, Binder S (2003) Autologous transplantation of retinal pigment epithelium after mechanical debridement of Bruch’s membrane. Curr Eye Res 26(2):81–88

    Article  PubMed  Google Scholar 

  • Pieramici DJ, De Juan E Jr, Fujii GY, Reynolds SM, Melia M, Humayun MS, Schachat AP, Hartranft CD (2000) Limited inferior macular translocation for the treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration. Am J Ophthalmol 130(4):419–428

    Article  PubMed  CAS  Google Scholar 

  • Robison CD, Krebs I, Binder S, Barbazetto IA, Kotsolis AI, Yannuzzi LA, Sadun AA, Sebag J (2009) Vitreomacular adhesion in active and end-stage age-related macular degeneration. Am J Ophthalmol 148(1):79–82.e72. doi:S0002-9394(09)00064-6, [pii] 10.1016/j.ajo.2009.01.014

    Article  PubMed  Google Scholar 

  • Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY (2006a) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355(14):1419–1431. doi:355/14/1419, [pii] 10.1056/NEJMoa054481

    Article  PubMed  CAS  Google Scholar 

  • Rosenfeld PJ, Rich RM, Lalwani GA (2006b) Ranibizumab: phase III clinical trial results. Ophthalmol Clin North Am 19(3):361–372

    PubMed  Google Scholar 

  • Ruiz-Moreno JM, de la Vega C (2001) Surgical removal of subfoveal choroidal neovascularisation in highly myopic patients. Br J Ophthalmol 85(9):1041–1043

    Article  PubMed  CAS  Google Scholar 

  • Singh RP, Patel C, Sears JE (2006) Management of subretinal macular haemorrhage by direct administration of tissue plasminogen activator. Br J Ophthalmol 90(4):429–431. doi:90/4/429, [pii] 10.1136/bjo.2005.085001

    Article  PubMed  CAS  Google Scholar 

  • Stanga PE, Kychenthal A, Fitzke FW, Halfyard AS, Chan R, Bird AC, Aylward GW (2002) Retinal pigment epithelium translocation after choroidal neovascular membrane removal in age-related macular degeneration. Ophthalmology 109(8):1492–1498

    Article  PubMed  Google Scholar 

  • Thomas MA, Grand MG, Williams DF, Lee CM, Pesin SR, Lowe MA (1992) Surgical management of subfoveal choroidal neovascularization. Ophthalmology 99(6):952–968

    PubMed  CAS  Google Scholar 

  • Uemura A, Thomas MA (2000a) Subretinal surgery for choroidal neovascularization in patients with high myopia. Arch Ophthalmol 118(3):344–350

    Article  PubMed  CAS  Google Scholar 

  • Uemura A, Thomas MA (2000b) Visual outcome after surgical removal of choroidal neovascularization in pediatric patients. Arch Ophthalmol 118(10):1373–1378

    Article  PubMed  CAS  Google Scholar 

  • van Meurs JC, ter Averst E, Hofland LJ, van Hagen PM, Mooy CM, Baarsma GS, Kuijpers RW, Boks T, Stalmans P (2004) Autologous peripheral retinal pigment epithelium translocation in patients with subfoveal neovascular membranes. Br J Ophthalmol 88(1):110–113

    Article  PubMed  Google Scholar 

  • Wong D, Stanga P, Briggs M, Lenfestey P, Lancaster E, Li KK, Lim KS, Groenewald C (2004) Case selection in macular relocation surgery for age related macular degeneration. Br J Ophthalmol 88(2):186–190

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

11.1 Electronic Supplementary material

Below is the link to the electronic supplementary material.

macula (539,416 KB)

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Williamson, T.H. (2013). Choroidal Neovascular Membrane. In: Vitreoretinal Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31872-6_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-31872-6_11

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-31871-9

  • Online ISBN: 978-3-642-31872-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics