RECURRENT CHOROIDAL NEOVASCULARIZATION AFTER LASER PHOTOCOAGULATION IN SORSBYS FUNDUS DYSTROPHY

Background: Patients with autosomal dominant Sorsby's fundus dystrophy are at high risk of severe visual loss due to choroidal neovasculariz ation (CNV) during the fourth or fifth decade of life. Methods: To ass ess the efficacy of argon laser photocoagulation for extrafoveal well- defined CNV, we analyzed retrospectively the clinical course in 10 eye s of 7 patients who had Sorsby's fundus dystrophy with CNV 200 mum to 2,500 mum from the center of the foveal avascular zone, and who subseq uently underwent laser photocoagulation. Results: All treated eyes dev eloped severe visual loss as a consequence of recurrent or persistent CNV occurring on the foveal side of the treatment scar, which extended under the fovea. The average time until occurrence of angiographicall y documented CNV after initial treatment was 8.1 +/- 8.9 weeks, but ra nged from 2 weeks to 32 weeks. Retreatment for persistent or recurrent extrafoveal CNV was performed in 5 eyes, but CNV recurred in all 5. C onclusions: Results of this study suggest that the risk of persistence or recurrence of CNV after laser photocoagulation for extrafoveal CNV is unusually high in patients with Sorsby's fundus dystrophy, and tha t this treatment is ineffective in preventing severe visual loss in su ch patients.