other types of wet ARMD and relevant pages

• 'Wet' ARMD..general details/all types

Each type alone

• Fibrovascular Pigment Epithelial Detachment:
  occult type 1
• Type 2 Occult CNV  
• Classic CNV   (this page)
• Polypoidal choroidal vasculopathy
  
  

Some dry types of macular degeneration progress to form this type of wet ARMD.

It is very difficult to predict whose dry ARMD will progress, but the risk factors include those mentioned above (soft drusen, high blood pressure, smoking, poor diet, lack of exercise).

When blood vessels grow under the macula, this is termed choroidal neovascularisation (CNV or CCNV).

When the new vessels are seen easily on a fluorescein angiogram, they are called 'classic CNV': They look like a net of blood vessels.

See a photo,   another , another , another (case 12) and a healthy fluorescein for comparison.

When a doctor looks in the retina looks elevated, there may be tiny haemorrhages, a grey area, or exudates. This photo is a severe case. In milder cases vision may still be good.

The condition may develop over days or weeks, with increasing distortion or blurred central vision. If this process is mild you can still read, but if it becomes severe reading with any magnifier is impossible.

Treatment, if possible, will be include new ant-VEGF drugs.

Laser  may help (see details of the Verteporfin treatment program) but is becoming less important as it is not effective as the new drugs.

If you notice the symptoms (central vision becoming distorted or blurred, sometimes like looking through water) you should have your eye checked: see distortion below.

This is usually a very serious type of macular degeneration, serious because it can cause very poor sight. It never blinds in the sense that you cannot see light and dark, but in its serious form it can damage the central vision so you can only see fingers or even the movements of hands. Once again, the side vision will normally be good, so you should always be able to walk around the house.

Surgery has not proved very helpful.

The CNV grow at 20microns/day, reaching 3000 microns in 6 months. They can be extremely difficult to see in early stages. Small membranes gain, on average, 5 lines of vision with the Lucentis.
The biggest problem is detecting them early, and much work ('Replacing the Amsler Grid")   is being carried out to detect early membranres.

The condition is occasionally unresponsive to treatment. Macugen is probably the least effective of the new anti-VEGF drugs, and even combined with laser may give a poor response.

New vessels growing under the central retina in a 'classic' pattern: PDT treatment may help