One of the most sight threatening eye conditions, a choroidal neovascular membrane is associated with several diseases that can lead to blindness.
What is the Choroid?
The choroid is the structure that supplies blood to the back of the retina. There are no blood vessels in the back part of the retina and the choroid is the only supply of blood and nutrients for this structure.
There are multiple layers that compose the choroid, starting with larger blood vessels and gradually getting smaller until reaching the retina.
One of the layers of the choroid is called Bruch’s Membrane. This layer is important for maintaining a healthy retina and preventing buildup of debris.
Damage to Bruch’s Membrane
When Bruch’s Membrane is damaged or there is a break in the membrane, the blood from the choroid can leak into the retina.
In addition to potential blood leakage, there can be waste buildup called drusen within the remaining portion of Bruch’s Membrane.
The damage to Bruch’s Membrane and leaking of fluid into the retina is the hallmark of a choroidal neovascular membrane.
Choroidal Neovascular Membrane
A choroidal neovascular membrane is a term that groups conditions that present with damage to Bruch’s membrane and fluid leakage into the retina.
All choroidal neovascular membranes are problems associated with the back portion of the retina and the choroid.
A choroidal neovascular membrane can cause damage to the retina and lead to vision loss.
Causes of Choroidal Neovascular Membranes
There are many eye conditions which can lead to a choroidal neovascular membrane.
The most prevalent condition is age related macular degeneration which is the leading cause of vision loss in the United States.
Other conditions which can cause a choroidal neovascular membrane include a fungal infection known as histoplasmosis, trauma resulting in choroidal rupture, an inherited retinal disease called Best’s Disease, high nearsightedness associated with retinal changes, and Angioid streaks from autoimmune conditions.
Choroidal Neovascular Membrane Caused by Age Related Macular Degeneration
The most prominent cause of a choroidal neovascular membrane is age related macular degeneration.
As the name of the condition implies, age related macular degeneration is a chronic, age dependent disease.
Macular degeneration affects Caucasians and women most frequently but not exclusively.
If the macular degeneration advances to a “wet” stage, then a choroidal neovascular membrane will form due to the damage to Bruch’s Membrane.
There is no cure for macular degeneration, but the treatment currently includes vitamin supplements in the form of AREDS 2 vitamins.
Choroidal Neovascular Membrane Caused by Other Conditions
Aside from macular degeneration, the causes of choroidal neovascular membranes are rarer and more unique in their disease course.
The unifying factor is the damage to Bruch’s Membrane which allows fluid into the retina. Whether Bruch’s Membrane is impacted by trauma or inflammation, the end result is still a choroidal neovascular membrane.
Treatment for a Choroidal Neovascular Membrane
Treatments for a choroidal neovascular membrane have advanced in recent years and improved the prognosis of vision greatly.
The current treatment of choice is intraocular injections of Anti-VEGF medication to reduce the neovascularization.
While these injections are not curative for the underlying condition, the Anti-VEGF medication has been shown to reduce the amount and severity of vision loss from a choroidal neovascular membrane.
An eye doctor can identify and manage the treatment for a choroidal neovascular membrane.
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