97th DOG Annual Meeting 1999
SURGICAL REMOVAL OF SUBMACULAR NEOVASCULAR MEMBRANES IN BIRDSHOT RETINOPATHY
R. Effert1, N. Bornfeld2
The surgical removal of parafoveal subretinal neovascular membranes in age-related macular degeneration has proved to be a worthwhile procedure. Experiences with membranectomies in diseases of inflammatory origin as Birdshot retinopathy are unclear.
Patients: We report about four white females aged between 35 and 44 years with Birdshot retinopathy. Apart from typical depigmented retinal spots five eyes presented with submacular membranes and a dramatic drop in central visual acuity. Progression could neither be influenced by high doses of steroids nor by radiotherapy. In one patient both eyes had submacular membranes surgically removed, the other cases were observed without further treatment.
Results: Cases without surgical treatment developed a big fibrous subretinal membrane with demarcated pigment epithelial detachment, loss of central vision and marked central scotoma. After surgery central visual acuity could be saved for three to six months before a recurrence in both eyes had to be operated again. Finally the visual acuity dropped to 20/400, but the central scotoma was significantly smaller than in the other not operated group.
Conclusion: Surgical removal of subretinal neovascular membranes in Birdshot retinopathy seems to create a better visual outcome than spontaneous forms without treatment, although recurrence after surgery is high.
1 Klinikum Kassel, Augenklinik, Mönchebergstr. 41 - 43, D-34125 Kassel
2 Univ.-Klinikum Essen, Zentrum für Augenheilkunde, Abt. für Erkrankungen des hinteren Augenabschnittes, Hufelandstr. 55, D-45147 Essen