Surgical removal of subfoveal choroidal neovascularization without removalof posterior hyaloid - A consecutive series in younger patients

Purpose: Subfoveal choroidal neovascularization (CNV) remains a common and important cause of visual loss. Previous studies have suggested that submac ular surgery may improve or maintain visual acuity, particularly in younger patients. The majority of reported cases included removal of the posterior hyaloid during vitrectomy. The authors present a consecutive series of pat ients age 55 or younger with subfoveal CNV removal without posterior hyaloi d removal. Methods: Seventeen patients without age-related macular degeneration (ARMD) , with subfoveal CNV from choroiditis, presumed ocular histoplasmosis syndr ome, myopia, or idiopathic causes, underwent a small retinotomy technique t o extract the membranes after vitrectomy without posterior hyaloid removal. Results: Median improvement in visual acuity was from 20/320 to 20/50. Elev en patients (65%) experienced an improvement of three or more lines of Snel len acuity (average 7.5), 4 (23%) were within two lines of preoperative acu ity, and 2 (12%) had decreased acuity, with an average follow-up of 12 mont hs (range 3-31). Choroidal neovascularization recurred in six patients (35% ). Postoperative retinal detachment, epiretinal proliferation, or macular h ole did not occur. Conclusions: In this series of younger patients with subfoveal CNV not from ARMD, visual acuity was improved in the majority after submacular membrane removal. Omission of removal of the posterior hyaloid did not adversely af fect outcome.