Neovascular Age-Related Macular Degeneration Associated With No Light Perception

BACKGROUND AND OBJECTIVE: To study eyes with no light perception (NLP) occurring secondary to neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Records of consecutive patients with neovascular AMD seen during a 10-year period were reviewed to ascertain which patients had NLP due to neovascular AMD. RESULTS: Ten of 1,150 patients (0.9%) with neovascular AMD had NLP in one eye (study eye) from neovascular AMD. All 10 patients had bilateral neovascular AMD. Each study eye had a large macular disciform scar and 360 degrees peripapillary subretinal fibrovascular tissue. Seven of nine (78%) study eyes had optic disc pallor, versus none of eight fellow eyes (P = .04). Mean fellow eye vision was 20/231, ranging from 20/50 to NLP (P = .006 vs study eyes). No seeing fellow eye had choroidal neovascularization encircling the optic disc (P = .0004). CONCLUSION: NLP from neovascular AMD is associated with 360 degrees peripapillary subretinal fibrosis. This fibrosis may cause chronic ischemic optic neuropathy contributing to extinguished vision.