Laser photocoagulation of subfoveal recurrent neovascular lesions in age-related macular degeneration. Results of a randomized clinical trial. Macular Photocoagulation Study Group.
In a randomized clinical trial, the effects of laser treatment of subfoveal recurrent neovascularization have been compared with no additional laser treatment. Among eyes with age-related macular degeneration assigned to laser treatment of recurrent neovascularization (n = 97) and those assigned to no additional laser treatment (n = 109), average visual acuity was 20/125 (Snellen equivalent) at entry. Both at 3 and 24 months after enrollment, the average visual acuity of laser-treated eyes was 20/250, indicating a decrease in visual acuity of 3 lines immediately after treatment, but little further decrease in acuity thereafter. In contrast, the average visual acuity of eyes assigned to no additional treatment decreased by 2 lines to 20/200 by 3 months after entry. After 24 months, acuity had decreased an additional 2 lines to 20/320. By 24 months after enrollment, only three (9%) of 35 laser-treated eyes, but 13 (28%) of 46 untreated eyes, had decreased visual acuity of 6 or more lines from baseline (P = .03, chi 2 test). On average, treated eyes maintained the initial contrast threshold for large letters, while the contrast threshold of untreated eyes worsened steadily throughout 24 months of follow-up. This study was halted before the target number of patients had been enrolled because of the similarity of these findings to findings from a related Macular Photocoagulation Study clinical trial of laser treatment of subfoveal neovascularization secondary to age-related macular degeneration in eyes without previous laser treatment. Laser treatment is recommended for subfoveal recurrent neovascularization in eyes with age-related macular degeneration that meet the eligibility criteria for this study.
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002829:Choroid / Q000098:blood supply* / Q000601:surgery; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis; D005654:Fundus Oculi; D006801:Humans; D008028:Light Coagulation; D008268:Macular Degeneration / Q000150:complications*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D012008:Recurrence; D016896:Treatment Outcome; D014792:Visual Acuity