Subretinal neovascularization with geographic (serpiginous) choroiditis

Three patients with geographic choroiditis developed subretinal neovascular membranes associated with subretinal hemorrhage and serous elevation of the retina. Proximity of the membrane to the foveal avascular zone prevented photocoagulation of the neovascular membrane in one patient. Central visual acuity remained 6/60 (20/200) despite systemic corticosteroid therapy. The neovascular membranes in the other two patients were obliterated by argon laser photocoagulation with preservation of central vision. The inflammatory process of geographic choroiditis can disrupt Bruch's membrane, allowing occasional choroidal vascular growth. Concomitant destruction of choroidal vessels may account for rarity of subretinal neovascularization in geographic choroiditis.