Changes in fluorescein angiogram early after surgical removal of choroidal neovascularization in age-related macular degeneration.

BACKGROUND

Retinal pigment epithelial (RPE) defects inevitably occur in surgical removal of choroidal neovascularization (CNV) in age-related macular degeneration (AMD). RPE can proliferate and cover the denuded area, but the healing process has not been investigated in humans. To understand the RPE wound-healing process, we estimated the changes in fluorescein angiograms early after CNV removal.

METHODS

Ten consecutive patients with exudative AMD underwent CNV removal without gas tamponade. Fluorescein angiography was performed within 4 days of surgery and again 1 or 2 weeks postoperatively. Areas of leakage were measured using a computer-assisted image analyser. The decreasing rate of leakage was calculated as the change in disc areas of leakage per day (DA/day).

RESULTS

The rates of decreasing leakage ranged from 0 to 0.42 DA/day (mean, 0.24 +/- 0.15 DA/day; median, 0.26 DA/day). The rate of decreasing leakage correlated with changes in visual acuity (r = 0.642, P = 0.0456).

CONCLUSION

The retinal pigment epithelial wound after surgical removal of choroidal neovascularization may heal at the rate of 0.24 disc areas/day based on the blood retinal barrier function in patients with age-related macular degeneration. A faster rate of decreasing leakage may be associated with better visual prognosis.