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

Graefes Arch Clin Exp Ophthalmol. 2002 Jan;240(1):12-6. doi: 10.1007/s004170100358.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Choroidal Neovascularization / diagnosis*
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / surgery*
  • Female
  • Fluorescein Angiography*
  • Humans
  • Macular Degeneration / complications*
  • Male
  • Middle Aged
  • Pigment Epithelium of Eye / physiology
  • Prospective Studies
  • Wound Healing / physiology