Biomicroscopic and histopathologic considerations regarding the feasibility of surgical excision of subfoveal neovascular membranes.

An understanding of the difference between the growth pattern of choroidal neovascularization within the subsensory retinal space, usually encountered in children and young adults, and that within the subpigment epithelial space, typically in older patients with age-related macular degeneration, is of fundamental importance in considering whether to surgically remove these subfoveal neovascular membranes. Their removal in young patients has some chance of restoring useful central visual function. Their removal in older patients will be associated with removal of the native pigment epithelium and little likelihood of restoration of function in the area of the membrane, unless some means are found to resurface the area with pigment epithelium.