Traumatic and Iatrogenic Choroidal Neovascularization

Choroidal ruptures, especially after blunt trauma play an important role in the pathogenesis of traumatic choroidal neovascularization (CNV). The development of CNV is more common in cases with more fragile Bruch’s membrane (BM) such as Angioid streaks (AS). Despite various differences between wet age-related macular degeneration (AMD), diagnostic methods and treatments until today are similar. Depending on the location and extent of the rupture, prognosis is better due to the relatively younger cases, fewer chronic diseases, small size of CNVs, fewer subfoveal localization and various regenerative mechanisms at the RPE level. Until the last decade, while thermal laser, photodynamic therapy, photocoagulation of the feeder vessels and excision of the CNVM have been applied for treatment, better and longer response is being achieved today by intravitreal antiVGEFs. However, more frequent injections may be needed in AS cases. Iatrogenic CNVs have been reported mostly due to high dose and low spot diameter applications of thermal lasers, and more rarely due to various ocular surgeries. Measures to be taken against the causes of trauma, especially occupational and traffic accidents, are of great importance in our country. Particularly laser and macula surgeries in branch specialist training, as well as high level of care and attention will reduce the risk of iatrogenic CNV. Experimental animal studies carried out with various factors, molecules and gene transfers are also promising in terms of pathogenesis and treatment.