Choroidal neovascularization is an eye condition where abnormal blood vessels form in the choroid, often due to age-related macular degeneration. It can cause vision loss but can be treated with medication or surgery. Diagnosis is done through fluorescein angiography, and treatment involves drug injections, laser surgery, or photodynamic therapy.
Choroidal neovascularization is a common eye problem that involves an abnormal collection of blood vessels in the protective layer of eye tissue called the choroid. The condition is closely associated with age-related macular degeneration (ARMD), although it can also occur in young people who suffer from eye injuries or infections. Vision loss is likely if the problem is not recognized and treated right away. Patients are often able to recover some of their vision with corrective medication or surgery.
The choroid is located just below the outermost layer of eye tissue. It is made up of tiny blood vessels that supply new oxygen to the retina. The inner layer of the choroid, known as Bruch’s membrane, also provides protection and cushioning for the inner eye. Choroidal neovascularization occurs when new blood vessels proliferate in the choroid due to a rupture or other abnormality of Bruch’s membrane. Doctors don’t fully understand why new blood vessels form, although they have identified several conditions that lead to their development.
Most cases of choroidal neovascularization are secondary to wet ARMD, a condition that begins when blood vessels under the retina expand and put pressure on Bruch’s membrane, eventually causing irritation or rupture. Wet ARMD is more likely to affect people over the age of 60. Some cases of choroidal neovascularization result from trauma to the eye, such as a chemical burn or a shard of glass lodged in the eye. Less commonly, tumors, birth defects, autoimmune diseases, or infections that reach the eye can damage Bruch’s membrane.
The most significant physical symptom of choroidal neovascularization is the gradual deterioration of vision. Vision problems usually start with a slight blurring and difficulty focusing ahead. Also, one eye may appear redder than usual as blood and fluids build up in front of the retina. Without treatment, blood vessels can eventually displace the retina or cause significant scarring of the underlying tissue, leading to total and permanent vision loss.
An eye doctor can usually diagnose the condition by performing a procedure called fluorescein angiography. The doctor first injects a fluorescent dye into the choroid, then takes a diagnostic image using a specialized X-ray machine. The dye penetrates blood vessels and shows up on imaging results, allowing the specialist to determine the nature and severity of the condition.
Treatment for choroidal neovascularization typically involves drug injections, laser surgery, or a combination of the two. A doctor can inject medications directly into the affected choroid to help prevent new blood vessels from building up further. A popular noninvasive procedure called photodynamic therapy involves exposing the choroid to high-intensity light waves in an attempt to ablate blood vessels. If you have severe choroidal neovascularization, a surgeon may be able to cut into the choroid and manually remove the scar tissue. Treatment outcomes vary based on the severity and underlying cause of the condition, but many patients experience relief after immediate care.
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