Laser photocoagulation for neovascular lesions nasal to the fovea. Results from clinical trials for lesions secondary to ocular histoplasmosis or idiopathic causes. Macular Photocoagulation Study Group
OBJECTIVE: To determine whether laser photocoagulation of peripapillary
choroidal neovascularization (CNV) or large neovascular lesions that are
located nasal to the fovea is beneficial with respect to preservation of
remaining vision--consistent with the overall study findings. PATIENTS AND
INTERVENTIONS: A total of 113 eyes (112 patients) having either
peripapillary CNV or CNV that was located nasal to the fovea and larger
than 750 microns in longest diameter associated with either ocular
histoplasmosis or idiopathic causes were identified from the eyes that were
randomly assigned to either laser photocoagulation or observation only in
clinical trials conducted by the Macular Photocoagulation Study Group. MAIN
OUTCOME MEASURES: Visual acuity and change in visual acuity from baseline
examination were compared for laser-treated and untreated eyes. RESULTS: At
the 3-year examination, 11% (6/54) of the treated eyes vs 41% (21/51) of
the untreated eyes had lost six or more lines of visual acuity (P <
.001). Among eyes with peripapillary lesions, 14% (3/22) of the treated
eyes vs 26% (6/23) of the untreated eyes had lost six or more lines of
visual acuity at the 3-year examination (P = .29). Among eyes with nasal
lesions, 9% (3/32) of the treated eyes vs 54% (15/28) of the untreated eyes
had lost six or more lines of visual acuity at the 3-year examination (P
< .001). CONCLUSION: Results from the subset of patients who had
extrafoveal or juxtafoveal peripapillary CNV or CNV that was located nasal
to the fovea were consistent with the beneficial results of treatment
observed in the entire group of eyes that were studied by the Macular
Photocoagulation Study Group.
