The management of subfoveal choroidal neovascular membranes and hemorrhage

At the beginning of the past decade (1990), the Macular Photocoagulation Studies (MPS) were underway evaluating the efficacy of the treatment of subfoveal choroidal neovascularization (CNV) with conventional lasers. When this proved to limit the loss of vision and give little chance for improving vision, vitreoretinal surgeons turned to surgical approaches to treating these lesions. The surgical excision of subfoveal CNV has been under study for the remainder of the decade with the recent addition of macular/retinal translocation to attempt vision improvement for these patients. Other modalities including interferon therapy and external beam irradiation have proven ineffective, but new laser studies may offer promise with photosensitizing chemicals. Despite much study a single therapy that can reliably return sight to the majority of patients has not been developed. This article reviews the various therapies of the 1990s and renders some thoughts for the future.