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Visual Prognosis in Eyes With Relatively Good Initial Visual Acuity

David R. Guyer, MD; Stuart L. Fine, MD; Maureen G. Maguire, PhD; Barbara S. Hawkins, MS; Sarah L. Owens, MD; Robert P. Murphy, MD

Arch Ophthalmol. 1986;104(5):702-705.

Abstract
• We determined the visual prognosis of 94 eyes in 92 patients having (1) agerelated macular degeneration, (2) a discrete choroidal neovascular membrane directly under the center of the foveal avascular zone (subfoveal), and (3) an initial visual acuity of 20/100 or better. Of the patients who were reexamined 24 months following their initial presentation, 77% had lost at least four lines of vision and 64% had lost at least six lines. Estimation of visual loss using a conservative assessment procedure showed four-line visual loss in 65% of the patients and six-line loss in 50%. In general, the better the visual acuity at the initial examination, the more likely the patient was to have a smaller choroidal neovascular membrane. These results suggest that it may be reasonable to consider a randomized clinical trial of laser photocoagulation for this group of patients with a relatively poor visual prognosis.

Author Affiliations
From the Retinal Vascular Center of the Wilmer Institute, The Johns Hopkins Medical Institutions, Baltimore.

Footnotes
Accepted for publication Dec 30, 1985.

Reprint requests to 229 Maumenee Bldg, Wilmer Institute, 600 N Wolfe St, Baltimore, MD 21205 (Dr Fine).

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