Functional and anatomical changes after surgery for retrofoveal neovascularization in age related macular degeneration

Purpose : The aim of this study was to evaluate the direct effect of surgic al treatment of subfoveolar neovascular membranes in age related macular de generation to macular functions. Patients and methods : Thirteen eyes of 13 patients were included in this s tudy. Macular function was assayed by visual acuity and central visual fiel d using the Octopus perimeter before surgery and in the first three post op erative months. Pre and post operative fluorescein angiography frames were digitalized and the size of each lesions were compared. Results : After a 3 months follow up, Visual acuity remained stable or impr oved in 66% of the patients. However, visual acuity was better than 0.1 in 15% of the patients. Central visual field comparison disclosed a significan t worsening of the retinal sensitivity in the 3 degree field surrounding th e central point. On fluorescein frames, submacular scar was 141% of the siz e of the neovascular membrane. After a mean follow up of 6.9 months (range 3-14), one case of recurrence occurred. A cataract was observed in 85% of t he phakic patients followed for more than six months. Conclusion : After a short term follow wp, surgery can stabilise visual acu ity, even though it remains poor. A worsening of the scotoma in the 3 degre es surrounding the central point is observed. However, patients noticed a s ubjective visual improvement in 62% of the case.