IATROGENIC CHOROIDAL NEOVASCULARIZATION FOLLOWING ARGON-LASER PHOTOCOAGULATION FOR CHOROIDAL MALIGNANT-MELANOMA

Background: Choroidal neovascularisation is known to occur following p hotocoagulation for choroidal melanomas. Its occurrence rate, possible causes and clinical impact were studied. Methods: Post-treatment fluo rescein angiograms were reviewed from 18 patients who had received arg on laser photocoagulation as sole treatment of their small choroidal m elanomas, to look for choroidal neovascularisation. Where it was found an assessment of its clinical impact was made. Results: choroidal neo vascularisation was found in 50% of cases. Choroidoretinal neovascular isation, found in five patients, caused vitreous haemorrhage in one pa tient but was otherwise benign. Choroidovitreal neovascularisation was found in four patients. It occurred early and altered their clinical management. Three of these patients had a vitreous haemorrhage, one of whom also suffered a retinal detachment. The three diabetic patients in the series all developed aggressive choroidovitreal neovascularisat ion. Tumour size, rumours location and number of treatment sessions di d not appear to affect the occurrence of choroidal reovascularisation, nor did other medical or ocular conditions except for diabetes. Concl usion: Choroidal neovascularisation occurs commonly after melanoma pho tocoagulation. Although sometimes benign, it can be aggressive, partic ularly in diabetic patients, in whom it might be better to consider di fferent forms of tumour treatment.