RECURRENT CHOROIDAL NEOVASCULARIZATION AFTER LASER PHOTOCOAGULATION IN SORSBYʼS FUNDUS DYSTROPHY

Abstract

Patients with autosomal dominant Sorsby's fundus dystrophy are at high risk of severe visual loss due to choroidal neovascularization (CNV) during the fourth or fifth decade of life. To assess the efficacy of argon laser photocoagulation for extrafoveal well-defined CNV, we analyzed retrospectively the clinical course in 10 eyes of 7 patients who had Sorsby's fundus dystrophy with CNV 200 microns to 2,500 microns from the center of the foveal avascular zone, and who subsequently underwent laser photocoagulation. All treated eyes developed severe visual loss as a consequence of recurrent or persistent CNV occurring on the foveal side of the treatment scar, which extended under the fovea. The average time until occurrence of angiographically documented CNV after initial treatment was 8.1 +/- 8.9 weeks, but ranged from 2 weeks to 32 weeks. Retreatment for persistent or recurrent extrafoveal CNV was performed in 5 eyes, but CNV recurred in all 5. Results of this study suggest that the risk of persistence or recurrence of CNV after laser photocoagulation for extrafoveal CNV is unusually high in patients with Sorsby's fundus dystrophy, and that this treatment is ineffective in preventing severe visual loss in such patients.