Surgical removal of peripapillary choroidal neovascularization associated with optic nerve drusen

Abstract

Purpose: To assess the anatomical and functional results after surgical removal of peripapillary choroidal neovascularization (CNV) associated with optic nerve head drusen.

Methods: A retrospective study was carried out on four eyes (four patients) undergoing vitrectomy, retinotomy, and removal of CNV associated with optic disk drusen. CNV was preoperatively demonstrated by fluorescein angiography in all cases. In three cases, the CNV had a subfoveal extension, and a serous-hemorrhagic retinal detachment was the cause of the central vision disturbance in the remaining one. Optic nerve head drusen were bilateral and were confirmed with computed tomography scan.

Results: Visual acuity (VA) improved in all cases after a follow-up ranging from 12 to 42 months. Preoperative VA was 20/200, 20/200, 20/50, and count fingers and final VA was 20/50, 20/25, 20/25, and 20/30, respectively. There was no evidence of CNV recurrence during the follow-up period.

Conclusion: The results of surgical removal of peripapillary CNV with macular involvement associated with optic nerve head drusen are very encouraging, especially if we consider the variable outcome of the natural course in these cases.