Gregg T. Kokame, MD (Honolulu, HI), Seijo Yamaoka, MD (Tokyo, Japan)


To report the results of surgical removal of extrafoveal peripapillary (SRNVMs) for elderly patients in whom visual acuity was threated or affected by subretinal fluid, subretinal exudate or PSRNVM growth toward the fovea.


Retrospective review of six eyes of six patients undergoing subretinal surgical removal of PSRNVMs via pars plana vitrectomy.


PSRNVMs were successfully removed in six eyes of six patients with initial preservation of foveal function. The preoperative Snellen VA ranged from 20/30 to counting fingers, and the best postoperative VA ranged from 20/25 to 20/40. The final visual acuity with a mean followup of 3 years (range, 6-63 months) was stable or improved in 83% (5 eyes) of cases, ranging from 20/25 to 20/80. Early recurrence of PSRNVM was noted only in 1 eye (17%) at 1 month after surgery and was successfully treated with laser photocoagulation. Late recurrence of CNV developed after 3 years in two eyes. Cataract developed in 3 of 4 phakic eyes.


PSRNVMs sparing the central fovea in elderly patients can be successfully removed surgically with initial preservation of foveal function and with a low rate of early recurrence.