BACKGROUND/AIMS: Eyes with burnt out disciform scars secondary to age related macular degeneration (AMD) are regarded as visually stable. The aim of this study is to report the subsequent development of atrophy of the retinal pigment epithelium (RPE) around the scars and discuss the possible basis. METHODS: 20 eyes from 18 patients were observed to develop atrophy around choroidal neovascularisation (CNV). A method of measuring expansion of the atrophy over time is described using the Topcon Imagenet 2000 system. An additional 10 clinicopathological examples were reviewed. RESULTS: Clinically CNV became surrounded initially by a ring of pallor that progressed to an expanding band of atrophy of the RPE. It developed most rapidly in the first 3 years after CNV became quiescent but then continued to expand slowly to more than three times the size of the scar. Histopathological specimens showed large choroidal vessels entering the scars directly and a reduced number of small choroidal vessels beneath and around the scar CONCLUSIONS: Disciform scars may become surrounded by an expanding band of atrophy of the RPE, postulated to result from remodelling of the choroidal circulation. The ongoing enlargement of the resulting scotoma may need to be considered when planning management and assessing treatment outcomes.
BACKGROUND/AIMS: Eyes with burnt out disciform scars secondary to age related macular degeneration (AMD) are regarded as visually stable. The aim of this study is to report the subsequent development of atrophy of the retinal pigment epithelium (RPE) around the scars and discuss the possible basis. METHODS: 20 eyes from 18 patients were observed to develop atrophy around choroidal neovascularisation (CNV). A method of measuring expansion of the atrophy over time is described using the Topcon Imagenet 2000 system. An additional 10 clinicopathological examples were reviewed. RESULTS: Clinically CNV became surrounded initially by a ring of pallor that progressed to an expanding band of atrophy of the RPE. It developed most rapidly in the first 3 years after CNV became quiescent but then continued to expand slowly to more than three times the size of the scar. Histopathological specimens showed large choroidal vessels entering the scars directly and a reduced number of small choroidal vessels beneath and around the scar CONCLUSIONS: Disciform scars may become surrounded by an expanding band of atrophy of the RPE, postulated to result from remodelling of the choroidal circulation. The ongoing enlargement of the resulting scotoma may need to be considered when planning management and assessing treatment outcomes.
Authors: A Bindewald; S Schmitz-Valckenberg; J J Jorzik; J Dolar-Szczasny; H Sieber; C Keilhauer; A W A Weinberger; S Dithmar; D Pauleikhoff; U Mansmann; S Wolf; F G Holz Journal: Br J Ophthalmol Date: 2005-07 Impact factor: 4.638
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Authors: Emma C Zanzottera; Thomas Ach; Carrie Huisingh; Jeffrey D Messinger; Richard F Spaide; Christine A Curcio Journal: Retina Date: 2016-12 Impact factor: 4.256
Authors: Emma C Zanzottera; Thomas Ach; Carrie Huisingh; Jeffrey D Messinger; K Bailey Freund; Christine A Curcio Journal: Retina Date: 2016-12 Impact factor: 4.256
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Authors: Juan E Grunwald; Ebenezer Daniel; Jiayan Huang; Gui-Shuang Ying; Maureen G Maguire; Cynthia A Toth; Glenn J Jaffe; Stuart L Fine; Barbara Blodi; Michael L Klein; Alison A Martin; Stephanie A Hagstrom; Daniel F Martin Journal: Ophthalmology Date: 2013-09-29 Impact factor: 12.079
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