The CNV (choroidal new vessels) grow near the optic nerve. At first the vision is good, as the fovea is not damaged. (The fovea is needed for sharp vision (reading, television, seeing faces etc).
But sometimes the new vessels later spread towards the fovea, and then vision is reduced. Often the new vessels themselves do not reach the fovea, but they cause leakage and bleeding, and this spreads towards the fovea, damaging the retina and reducing vision. Anti-VEGF treatment is needed.
Unless the new vessels leak or bleed treatment, is not needed. Patients are usually kept under observation. Sometimes the condition dries up by itself, and then patients no longer need regular checkups.
Retina 19 "Peripapillary choroidal neovascularization secondary to wet age-related macular degeneration has a slow progression, may not require treatment for a prolonged period, and responds rapidly to anti–vascular endothelial growth factor treatment with good visual outcomes."
Peripapillary CNV; treatment is only needed if the vision is affected by the new vessels growth directly, but more usually by leaking or bleeding from the CNV. This happens when the fovea (yellow spot in this diagram) is affected.
Anti-VEFG BJO 20