الفهرس 
Introduction of CNVOnly 14 pages are availabe for public view
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Abstract
Choroidal neovascularization is a leading cause of loss of central vision in developed countries. It disrupts the anatomy of the retinal pigment epithelium-photoreceptor complex, leaks serum and sometimes blood, and often in the end is accompanied by irreversible scar formation that is associated with a loss of photoreceptors. It is encountered most often in patients with Age related Macular Degeneration.
The assessment of CNV using Fluorescein angiography is well established. It is used to identify the foveal avasccular zone, locate its center, and outline the area of neovascularization before treatment.
Indocyanine green angiography is a useful diagnostic tool for imaging of choroidal circulation. It is useful in the evaluation of patients with occult choroidal neovascularization associated with age related macular degeneration.
Optical Coherence Tomography is a new diagnostic imaging technique that is extremely effective in distinguishing between neurosensory detachment and retinal pigment epithelium detachment. Optical Coherence Tomography offers an objective test for serial, quantitative evaluations of retinal thickness. It may have utility in defining surgically approachable membranes in age related macular degeneration and it holds promise for defining the borders of choroidal neovascularization that are poorly defined by Fluorescein angiography.
Surgical treatment including: Surgical excision of subfoveal choroidal neovascular membrane through vitreoretinal techniques may be used in cases with limitation of other treatment modalities, Macular translocation surgery is a procedure designed to move the fovea away from an area of disease of the retinal pigment epithelium and/or choroid to an area of healthier underlying tissue.
In pharmacotherapy, Vascular endothelial growth factor plays an important role in angiogenesis, so anti-VEGF has become a natural target for new therapies inchoroidal neovascularization. Also, Intravitreal steroids is used in patients with occult or predominantly occult subfoveal neovascularization.
Radiotherapy has been proposed as an experimental treatment for choroidal neovascularization complicating age related macular degeneration. Radiation is antiangiogenic and is toxic to vascular tumors and endothelial cells.
Laser therapy using: Laser photocoagulation is potentially beneficial in the treatment of extrafoveal and juxtafoveal choroidal neovascularization with well defined margins but the recurrence rate is greater than 50%. Photodynamic therapy can be used to treat diseased tissue selectively while sparing adjacent normal tissue. Transpupillary thermotherapy appears to have a definite role in the treatment of choroidal neovascularization secondary to age related macular degeneration.
Future directions as retinal transplantation, gene therapy and visual implants are still under trial.