Choroidal Neovascular membrane
OVERVIEW
Choroidal neovascular membrane (CNVM) is a problem that is related to a wide variety of retinal diseases, but is most commonly linked to age-related macular degeneration. With CNVM, abnormal blood vessels stemming from the choroid (the blood vessel-rich tissue layer just beneath the retina) grow up through the retinal layers. Imagine the abnormal blood vessels as weeds creeping up through the cracks of a sidewalk. These new vessels are very fragile and break easily, causing blood and fluid to pool within the layers of the retina.
As the vessels leak, they disturb the delicate retinal tissue, causing the vision to deteriorate. The severity of the symptoms depends on the size of the CNVM and its proximity to the macula. Patients’ symptoms may be very mild such as a blurry or distorted area of vision, or more severe, like a central blind spot.
SIGNS AND SYMPTOMS
- Blurred, grayed-out areas
- Distorted vision
- Central blind spot
DETECTION AND DIAGNOSIS
A simple vision test called an
Amsler Grid should always be done
first for patients who notice a problem with their central vision.
This test provides the retina doctor with vital information about
the location and severity of the problem. CNVM is usually difficult
to diagnose by simply looking at the retina with an
ophthalmoscope. A special
dye test called a
fluorescein angiogram is used to study the circulation of the
retina and show areas of leaking blood vessels.
TREATMENT
The appropriate treatment is
dependent on several factors such as: size and location of the
membrane and the amount of time that passed since the symptoms first
began. If the CNVM is small, compact, and caught very early, a
delicate surgery called a sub-foveal excision can be performed to
remove it. This procedure has the most risk but also offers the
patient the best possibility of visual improvement.
Laser photocoagulation, a procedure that seals leaking blood
vessels, is the simplest and most common treatment for CNVM. It is
reserved for patients with bleeding outside of the central retina
because it creates a scar that affects the vision. Treating the
retina with laser gives the surgeon the most control over placement
and size of the scar. Allowing an undiagnosed leak to resolve on its
own usually causes a much more devastating affect on the vision.
Unfortunately, for some patients, no treatment is appropriate. All
patients with CNVM should monitor their vision with an
Amsler Grid and report any changes
to their retinal doctor immediately.
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