As a special lecture at the 95th annual Congress of the Japanese Ophthalmological Society in 1991, we presented experimental studies on
choroidal neovascularization (ChNV), and clinical studies on senile disciform
macular degeneration (exudative
age-related macular degeneration). We produced experimentally ChNV on monkey eyes using intense
photocoagulation with
krypton laser. We showed the retinal pigment epithelium (RPE) played a heavy role as inducer or inhibitor for ChNV at different stages of development or involution of experimental ChNV. Senile disciform
macular degeneration is becoming a leading cause of
blindness in the elderly in Japan. We examined 473 eyes in 398 cases of this disease during the past 5 years. Nineteen percent were bilaterally affected, males were affected 3 times prevalent than in female, and average age was 67 in years. Predisposing signs were degeneration or
atrophy of RPE, hard or soft drusen, and serous detachment of RPE in the macula. In early stage, serous
retinal detachment stage appeared and showed good outcome by
laser treatment. Subretinal
hematoma form showed next better outcome in acute onset and acute course. Advanced form of disciform lesion showed worse outcome. A form (subretinal cystic form) associated with large serous RPE detachment showed the worst outcome and scarcely indicated for
laser treatment. We describe clinical features of each form and stages of the disease and
clinical course. Early detection, early correct diagnosis and early
laser treatment must be essential for prevention of
blindness due to this disease.