FLUORESCEIN ANGIOGRAPHIC MORPHOLOGY OF RE CURRENT CHOROIDAL NEOVASCULARIZATION AFTER SURGICAL MEMBRANECTOMY IN AGE-RELATED MACULAR DEGENERATION

The surgical removal of choroidal neovascularization (CNV) in age-rela ted macular degeneration (AMD) causes a retinal pigment epithelial def ect (RPED) corresponding to the area of diffuse RPE damage. We describ e angiographic features of recurrent CNV in AMD after surgical membran ectomy in order to elucidate the nature of persistence and recurrence. Methods: After digitalization of the pre- and postoperative fluoresce in angiographic images of eight patients with recurrent CNV in AMD we determined the morphology (well or ill-defined) and the area of the CN V and of the subretinal hemorrhage preoperatively and of the recurrent CNV and of the RPE defect postoperatively. Results: The nature of rec urrences showed differences between preoperatively well- and ill-defin ed CNV. Four preoperatively well-defined CNV with surrounding subretin al hemorrhage showed recurrences in the entire area of the preoperativ e CNV excluding the retinotomy 8-9 weeks postoperatively. Four preoper atively ill-defined CNV with subretinal hemorrhage developed marginal recurrences at the rim of the RPED. There was no background fluorescen ce in the area of the RPED. Conclusion: The nature of recurrences exte nding over the entire area of the preoperatively well-defined CNV with out lass of background fluorescence only a few weeks after surgical re moval of well-defined CNV suggests partial persistence. The removal of the subretinal well-defined CNV could leave sub-RPE parts in location s that preoperatively cannot be visualized angiographically. The margi nal recurrence of preoperatively ill-defined CNV weeks to months posto peratively shows angiographic similarities to recurrent CNV after lase r coagulation.