This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Posterior Pole Appearance and Retinal Function

Robyn H. Guymer, MD, PhD; Mirjam Gross-Jendroska, MD; Sarah L. Owens, MD; Alan C. Bird, MD; Fredrick W. Fitzke, PhD

Arch Ophthalmol. 1997;115(5):595-603.

Abstract
Objectives
To verify that a few laser lesions in the posterior pole can cause drusen to resolve in patients with age-related macular degeneration, and to document central retinal sensitivity as drusen resolve.

Design
In a pilot study, 12 patients considered to be at high risk for sight-threatening complications from age-related macular degeneration were treated with 12 argon laser lesions in the posterior pole, with review for 12 to 24 months.

Results
Choroidal neovascularization developed in 1 patient 8 months after treatment, with consequent loss of central vision. In 9 of the remaining 11 patients, high-risk characteristics of drusen were reduced. Four patients had retinal pigment epithelial depigmentation, and all maintained 20/40 visual acuity at 12 months. One patient lost 3 lines of vision due to geographic atrophy after 12 months. Scotopic retinal threshold was elevated before treatment in 8 patients, compared with an age-matched comparison group. Of these, 4 patients underwent retesting 3 to 6 months after treatment, and all had improved thresholds, but only 1 patient sustained the improvement at 12 months. At 12 months, 3 of the 8 patients showed an improvement in their mean retinal threshold. Of those in whom the mean retinal threshold worsened, the mean elevation in threshold was not more than 0.6 log units.

Conclusions
A few laser lesions in the posterior pole leads to resolution of drusen. There does not appear to be an increased risk for choroidal neovascularization. Retinal threshold measurements show no indication of geographic atrophy at 1 year, but cannot be excluded as a late outcome. Laser treatment may reduce the risk for profound sightthreatening lesions in age-related macular degeneration.

Author Affiliations
From the Departments of Clinical Ophthalmology (Drs Guymer, Gross-Jendroska, Owens, and Bird) and Visual Science (Dr Fitzke), Institute of Ophthalmology and Moorfields Eye Hospital, London, England.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Functional aspects of drusen regression in age-related macular degeneration
Sallo et al.
Br J Ophthalmol 2009;93:1345-1350.
ABSTRACT | FULL TEXT  

Correlation of Functional Impairment and Morphological Alterations in Patients With Group 2A Idiopathic Juxtafoveal Retinal Telangiectasia
Schmitz-Valckenberg et al.
Arch Ophthalmol 2008;126:330-335.
ABSTRACT | FULL TEXT  

Maculopathy Due to the R345W Substitution in Fibulin-3: Distinct Clinical Features, Disease Variability, and Extent of Retinal Dysfunction.
Michaelides et al.
IOVS 2006;47:3085-3097.
ABSTRACT | FULL TEXT  

Further validation of the Daily Living Tasks Dependent on Vision: identification of domains
Hart et al.
Br J Ophthalmol 2005;89:1127-1130.
ABSTRACT | FULL TEXT  

Spare the rod and spoil the eye
Arden et al.
Br J Ophthalmol 2005;89:764-769.
ABSTRACT | FULL TEXT  

Comparison of Fundus Autofluorescence with Photopic and Scotopic Fine-Matrix Mapping in Patients with Retinitis Pigmentosa and Normal Visual Acuity
Robson et al.
IOVS 2004;45:4119-4125.
ABSTRACT | FULL TEXT  

Photopic and Scotopic Fine Matrix Mapping of Retinal Areas of Increased Fundus Autofluorescence in Patients with Age-Related Maculopathy
Scholl et al.
IOVS 2004;45:574-583.
ABSTRACT | FULL TEXT  

Expression of Metalloproteinases from Human Retinal Pigment Epithelial Cells and Their Effects on the Hydraulic Conductivity of Bruch's Membrane
Ahir et al.
IOVS 2002;43:458-465.
ABSTRACT | FULL TEXT  

Influence of laser photocoagulation on choroidal capillary cytoarchitecture
Guymer et al.
Br J Ophthalmol 2001;85:40-46.
ABSTRACT | FULL TEXT  

Psychophysical Evidence for Rod Vulnerability in Age-Related Macular Degeneration
Owsley et al.
IOVS 2000;41:267-273.
ABSTRACT | FULL TEXT  

Tissue Effects of Subclinical Diode Laser Treatment of the Retina
Pollack et al.
Arch Ophthalmol 1998;116:1633-1639.
ABSTRACT | FULL TEXT  

Alternative therapies in exudative age related macular degeneration
CHONG and BIRD
Br J Ophthalmol 1998;82:1441-1443.
FULL TEXT  

Prophylactic laser treatment in early age related maculopathy reduced the incidence of exudative complications
Frennesson and Nilsson
Br J Ophthalmol 1998;82:1169-1174.
ABSTRACT | FULL TEXT