Peripapillary subretinal neovascular membranes: the natural history

We studied the natural course of peripapillary subretinal neovascular membranes in 20 eyes. The membranes were either idiopathic in nature or associated with underlying disease. We found that the visual prognosis was related to the behaviour of the membrane and to the patient's age. Patients under the age of 40 years had unilateral disease and a more favourable visual prognosis. Older patients had a uniformly poor visual prognosis and a high incidence of bilateral disease. Fifty-four per cent of patients over 45 years and 62% over 70 years of age had bilateral membranes. In those over the age of 70 years, 75% of untreated eyes lost vision to a level of 3/60 or less in both eyes. The probability of the second eye becoming involved in the older group of patients was 62%. The period of time elapsing between involvement of the first and second eye varied between simultaneous occurrence and a delay of 7 years.