Choroidal Neovascularization in Black Patients

Objective: To characterize choroidal neovascularization (CNV) in black patients examined at a retinal disease referral center. Design: Retrospective review of the medical records of all patients diagnosed as having CNV to identify black patients with CNV. Setting: Single tertiary retinal referral center that included four ophthalmologists. Patients: All patients diagnosed as having CNV between April 1990 and October 1992. Main Outcome Measures: Prevalence, demographic information, fundus photographic and fluorescein angiographic characteristics, natural history, and response to laser photocoagulation of CNV in black patients. Results: Black patients comprise 15% of all patients seen at this center. Of 1725 patients identified as having CNV who were seen at the center during a 2.5-year period, only 25 were black (1.4%). In these patients, CNV was associated with a variety of retinal diseases, the most frequent being age-related macular degeneration. The average age of the study group was 54 years, women outnumbered men 2:1, and 13 of the patients developed bilateral lesions. Twelve of the 38 lesions were extrafoveal on presentation, and five of these were peripapillary. In the laser-treated eyes, recurrence of CNV was frequent and associated with visual loss. Conclusions: Choroidal neovascularization seems to be rare in blacks among a retinal disease referral center population. The overall presentation, natural history, and response to laser treatment seems to be similar to that of white patients. No feature of CNV in black patients was identified that would suggest that results of randomized clinical trials of laser photocoagulation for CNV are not valid for these patients.