Case 122 Teaching Points

Peripapillary choroidal neovascularization is usually seen in association with other diseases, such as age-related macular degeneration or presumed ocular histoplasmosis syndrome
When found in isolation it is termed idiopathic; it is generally seen in females in their 50s-60s
There is a high incidence of bilateral involvement and the fellow asymptomatic eye should be carefully examined and screened with fluorescein angiography
Patients <40 years-old with unilateral involvement tend to have a favorable course and should be managed conservatively unless the fovea is threatened
Patients >40 years-old and with bilateral disease all have a progressive course and should be treated with laser photocoagulation. There is also a rationale for the use of anti-vascular endothelial growth factor therapy, although no published clinical evidence is available.

References

Silvestri G, Archer DB, Johnston PB. Peripapillary subretinal neovascular membranes: the natural history. Eye 1993;7:398–402.

Last Modified: Wednesday, 28-May-2008 14:48:06 EDT