[Choroidal neovascularization, experimental and clinical study]

As a special lecture at the 95th annual Congress of the Japanese Ophthalmological Society in 1991, we presented experimental studies on choroidal neovascularization (ChNV), and clinical studies on senile disciform macular degeneration (exudative age-related macular degeneration). We produced experimentally ChNV on monkey eyes using intense photocoagulation with krypton laser. We showed the retinal pigment epithelium (RPE) played a heavy role as inducer or inhibitor for ChNV at different stages of development or involution of experimental ChNV. Senile disciform macular degeneration is becoming a leading cause of blindness in the elderly in Japan. We examined 473 eyes in 398 cases of this disease during the past 5 years. Nineteen percent were bilaterally affected, males were affected 3 times prevalent than in female, and average age was 67 in years. Predisposing signs were degeneration or atrophy of RPE, hard or soft drusen, and serous detachment of RPE in the macula. In early stage, serous retinal detachment stage appeared and showed good outcome by laser treatment. Subretinal hematoma form showed next better outcome in acute onset and acute course. Advanced form of disciform lesion showed worse outcome. A form (subretinal cystic form) associated with large serous RPE detachment showed the worst outcome and scarcely indicated for laser treatment. We describe clinical features of each form and stages of the disease and clinical course. Early detection, early correct diagnosis and early laser treatment must be essential for prevention of blindness due to this disease.