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A disciform scar is a severe, permanent, fibrous scar that forms under the macula, the central part of the retina. The scar represents the end-stage damage caused by abnormal blood vessel growth and leakage, typically seen in advanced wet age-related macular degeneration (AMD).
read more about disciform scar ...The scar is caused by the chronic activity of choroidal neovascularization (CNV), where abnormal, fragile blood vessels grow beneath the retina. These fragile vessels leak blood and fluid, damaging the delicate photoreceptor cells of the macula. When the body attempts to heal this repeated damage, it replaces the retinal tissue with a thick, elevated patch of scar tissue (the disciform scar). This permanent scarring destroys the underlying vision cells.
Symptoms are associated with irreversible central vision loss. Patients experience a dense, fixed blind spot (scotoma) in the center of their vision, severe blurring, and profound visual distortion (metamorphopsia). The vision loss is permanent in the scarred area and cannot be corrected with glasses or contact lenses. The scar is the main reason for functional vision failure.
The dense scar tissue blocks light from reaching the photoreceptors. The scar is a non-functional barrier, meaning the affected area cannot perceive any light, resulting in a dark, fixed patch in the center of the patient's visual field.
Diagnosis involves a extensive dilated eye exam. Optical Coherence Tomography (OCT) provides a cross-sectional image that clearly shows the elevation and structure of the scar tissue beneath the retina. Fluorescein angiography confirms the absence of active blood vessel leakage once the scar has matured.
Management strategies focus on preventing further scarring in the affected eye and protecting the vision in the fellow eye. Treatment involves controlling the initial abnormal vessel growth with anti-VEGF injections. Low-vision rehabilitation is often needed to help the patient adapt to using their remaining peripheral vision.
No, the scar tissue is permanent and the vision lost cannot be restored.
The scar is the end-stage of wet age-related macular degeneration (AMD).
No, the scarring process is painless, but the visual symptoms are severe.
A disciform scar represents the final stage of untreated bleeding in the macula. If you have "Wet" AMD, the goal of regular eye injections is to prevent this scar from forming. Once a scar forms, central vision is usually lost; a doctor will then focus on maximizing your remaining side vision.
AAO. Macular Degeneration Complications (aao.org). 2024.
Mayo Clinic. Macular Scars (mayoclinic.org). 2024.
StatPearls. Wet Age-Related Macular Degeneration (ncbi.nlm.nih.gov). 2024.
Cleveland Clinic. AMD Progression (clevelandclinic.org). 2024.