Guthoff R., Schumann S., Schrader W. F.

Universitätsaugenklinik Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany

Objective: Analysis of the outcome of visual acuity, surgical complications and recurrence rates 3 years after removal of choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD).
Patients and methods: The records for 95 consecutive patients undergoing surgical excision of CNV of Würzburg University eye Department from 1996 until 1998 were analyzed retrospectively. Indication for surgery was a subfoveal lesion size of 3 disc areas or more, history of visual symptoms of 3 months or less and visual acuity of 20/100 or less. 34 patients were followed up for a period of 36 month or more. Visual acuity, biomicroscopic findings and fluorescein angiograms were studied. Improvement or worsening of visual acuity were defined as a change of more than 2 lines.
Results: The mean reduction in visual acuity was 1.6 ± 6.5 lines. At the 3- year examination final visual acuity improved in 8 patients, remained stable in 16 patients, and worsened in 10 patients. 2 patients reachieved reading vision. Recurrence of CNV was noted in 1 patient. Surgical complications included phtisis bulbi in 1 patient and mature cataract in 3 patients. The average follow-up period was 45.7 months.
Conclusions: After surgical excision of age-related subfoveal CNV, visual acuity improved or stabilized in the majority of patients. According to the development of visual acuity and the low recurrence rate surgical treatment may have a benefit compared with the natural course, also with a follow up of at least 3 years.

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