CHORIORETINAL DAMAGE CAUSED BY THE EXCISION OF CHOROIDAL NEOVASCULARIZATION

PURPOSE: To determine whether choroidal neovascularization excision ca uses mechanical damage to the neurosensory retina, retinal pigment epi thelium, or choriocapillaris. METHODS: Prospectively, 18 eyes of 18 co nsecutive patients who underwent choroidal neovascularization excision were observed. Preoperatively and postoperatively, the integrity of t he choriocapillaris circulation in the pathway of choroidal neovascula rization extraction was studied by fluorescein and indocyanine green a ngiography. Using static scanning laser ophthalmoscope microperimetry, the presence of iatrogenic scotomas that developed postoperatively in the pathway of choroidal neovascularization extraction was also inves tigated. RESULTS: Postoperatively, a choriocapillaris defect was detec ted in 17 (94.4%) of 18 cases. In 15 cases (83.3%), the choriocapillar is defect had a clear relationship to the pathway of choroidal neovasc ularization extraction. Postoperatively, a scotoma was present in 16 ( 88.9%) of 18 cases. In 14 cases (77.8%), the location of the scotoma h ad a clear relationship to the pathway of choroidal neovascularization extraction. CONCLUSION: Surgical excision of choroidal neovasculariza tion leads to severe damage of the choroid and retina in the pathway o f the extracted choroidal neovascularization, The injury involves the neurosensory retina, retinal pigment epithelium, and choriocapillaris. (C) 1998 by Elsevier Science Inc. All rights reserved.