Choroidal neovascularisation at a demarcation line: an immunopathological study

Experimentally detached retina in cats has been shown to possess higher angiogenic activity than normal attached retina. 6 Indeed, peripheral retinal neovascularisation has been described in chronic rhegmatogenous retinal detachment. 7 Retinal detachment is likely to lead to compromised metabolism and hypoxia of the outer retinal layers due to elevation of the retina from the choroid. 6 RPE cells may secrete VEGF in response to this hypoxic insult and also secondary to mechanical stress incurred at the edge of the demarcation line. 8 9 VEGF may then stimulate the recruitment and activation of monocytes, which in turn could promote mediators of angiogenesis. 10 It is therefore possible that the liberation of neovascular growth factors in this setting may have contributed further to the development of CNVM in our patient.