Laser photocoagulation of subfoveal recurrent neovascular lesions in age-related macular degeneration. Results of a randomized clinical trial. Macular Photocoagulation Study Group

Arch Ophthalmol. 1991 Sep;109(9):1232-41. doi: 10.1001/archopht.1991.01080090056026.

Abstract

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging
  • Choroid / blood supply*
  • Choroid / surgery
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fovea Centralis
  • Fundus Oculi
  • Humans
  • Light Coagulation*
  • Macular Degeneration / complications*
  • Middle Aged
  • Neovascularization, Pathologic / etiology
  • Neovascularization, Pathologic / surgery*
  • Postoperative Complications
  • Recurrence
  • Treatment Outcome
  • Visual Acuity