 |
|
Macular Scatter ('Grid') Laser Treatment of Poorly Demarcated Subfoveal Choroidal Neovascularization in Age-Related Macular DegenerationResults of a Randomized Pilot Trial
Neil M. Bressler, MD;
Maureen G. Maguire, PhD;
Patrick L. Murphy, MD;
Judith Alexander;
Raymond Margherio, MD;
Andrew P. Schachat, MD;
Stuart L. Fine, MD;
Thomas S. Stevens, MD;
Susan B. Bressler, MD
Arch Ophthalmol. 1996;114(12):1456-1464.
Abstract
| |
Objectives
To determine the effects of macular scatter ("grid") laser photocoagulation compared with observation on the visual function of eyes with subfoveal choroidal neovascularization (CNV) that has poorly demarcated boundaries and to provide preliminary data for the evaluation of the feasibility and design of a larger, definitive trial.
Design
Randomized pilot clinical trial.
Setting
Two tertiary care retinal referral practices.
Patients
Symptomatic individuals with subfoveal CNV secondary to age-related macular degeneration in whom fluorescein angiography showed occult CNV with poorly demarcated boundaries; classic CNV was allowed but did not need to be present for entry into the study.
Main Outcome Measure
Change in visual acuity from baseline to specified time periods.
Results
Fifty-two eyes were assigned to observation. Fifty-one eyes were assigned randomly to treatment consisting of macular scatter ("grid") laser photocoagulation to the area of CNV. The treatment protocol for 8 of these eyes also included confluent laser photocoagulation to areas of classic CNV. The average visual acuity decrease from baseline was greater in the treated than in the observed group. The difference between these groups was greatest within the first year after study enrollment. At 24 months, slightly more than 40% of the eyes in each group had lost 6 or more lines of visual acuity. Similar results were noted for the subgroup of eyes initially with angiographic features of occult CNV but no classic CNV.
Conclusions
These short-term study results suggest that macular scatter ("grid") laser treatment is not beneficial and is possibly harmful compared with observation for symptomatic subfoveal CNV with poorly demarcated boundaries in age-related macular degeneration. With or without treatment, a significant proportion of these patients are at risk of severe visual loss within 2 years of seeking treatment, even when the eye initially has occult CNV and no classic CNV.
Author Affiliations
From the Retinal Vascular Center of the Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine and Hospital, Baltimore, Md (Drs N. M. Bressler, Schachat, and S. B. Bressler and Ms Alexander); The Scheie Eye Institute, University of Pennsylvania, Philadelphia (Drs Maguire and Fine); University Eye Associates, Wayne State University, St Clair Shores, Mich (Dr Murphy); Associated Retinal Consultants, Royal Oak, Mich (Dr Margherio); and the Department of Ophthalmology, University of Wisconsin, Madison (Dr Stevens).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Treatment of Retinal Angiomatous Proliferation in Age-Related Macular Degeneration: A Series of 104 Cases of Retinal Angiomatous Proliferation
Bottoni et al.
Arch Ophthalmol 2005;123:1644-1650.
ABSTRACT
| FULL TEXT
Extracts from "Clinical Evidence": Age related macular degeneration
Arnold and Sarks
BMJ 2000;321:741-744.
FULL TEXT
Radiotherapy for isolated occult subfoveal neovascularisation in age related macular degeneration: a pilot study
Donati et al.
Br J Ophthalmol 1999;83:646-651.
ABSTRACT
| FULL TEXT
Indocyanine green guided laser photocoagulation in patients with occult choroidal neovascularisation
Weinberger et al.
Br J Ophthalmol 1999;83:168-172.
ABSTRACT
| FULL TEXT
Occult Choroidal Neovascularization in Age-Related Macular Degeneration: A Natural History Study
Stevens et al.
Arch Ophthalmol 1997;115:345-350.
ABSTRACT
The Peril of the Pilot Study
Ferris and Murphy
Arch Ophthalmol 1996;114:1506-1507.
ABSTRACT
|
