[Photocoagulation of age-related juxtapapillary choroidal neovascularisation]

The aim of this study was to evaluate retrospectively the clinical outcome of retinal photocoagulation of age-related juxtapapillary choroidal neovascularisation (CNV) with macular oedema. Juxtapapillary CNV represents a rare form of extrafoveal CNV in age-related macular degeneration (AMD).

In 15 eyes of 14 patients with age-related juxtapapillary choroidal neovascularisation, CNV was treated with several rows of frequency doubled Nd:YAG laser (532 nm) irradiation to protect the fovea. Classification of the CNV was performed with fluorescein angiography. Best corrected visual acuity was determined before and after photocoagulation. Follow-up time was 1 - 32 months.

In 13 eyes the juxtapapillary CNV was occult (87 %), one eye had a classic, one eye a minimally classic form. In 13 eyes (87 %) the centre of the fovea showed macular oedema in spite of the extrafoveal location of the CNV. Of these 13 eyes, in 10 eyes (77 %) visual acuity increased after photocoagulation. 7 eyes (53 %) had an increase in visual acuity of 1 or 2 lines, 3 eyes of ≥ 4 lines. 2 eyes showed a stable visual acuity, in 1 eye visual acuity deteriorated after photocoagulation. In 2 eyes without foveal involvement of macular oedema, CNV was located in the papillo-macular bundle and threatened the centre of the fovea. Postoperative visual acuity in theses eyes was stable after 1 and 5 months.

The therapeutic benefit of photocoagulation of juxta- and extrafoveal classic CNV has already been proven. According to our results, photocoagulation is an effective therapeutic approach in the treatment of age-related juxtapapillary CNV especially, in the occult form, when the fovea is threatened by or involved in the macular oedema.