Laser photocoagulation for juxtafoveal choroidal neovascularization. Five-year results from randomized clinical trials. Macular Photocoagulation Study Group.

To summarize findings from three randomized clinical trials of krypton laser treatment of juxtafoveal neovascular lesions regarding changes in visual acuity during 5 years of follow-up, rates of persistent and recurrent choroidal neovascularization, and status of macular lesions 5 years after enrollment. DESIGN, PATIENTS, AND PRIMARY OUTCOME MEASURES: Follow-up of patients enrolled in three randomized trials of choroidal neovascularization secondary to age-related macular degeneration (AMD), ocular histoplasmosis, or idiopathic causes ended in March 1991. All patients were eligible to complete at least 3 years of follow-up examinations. Data on visual acuity, reading vision, and anatomic outcomes during 5 years of follow-up were available for 276 (92%) of 300 patients with AMD, 236 (92%) of 256 patients with ocular histoplasmosis, and 38 (97%) of 39 patients with idiopathic choroidal neovascularization enrolled 5 or more years earlier who were still living.
Among eyes with AMD, the estimated relative risk (RR) of a loss of 6 or more lines of visual acuity from baseline to any examination from 6 months through 5 years after enrollment for untreated eyes in comparison with treated eyes was 1.20 (P = .04). Normotensive patients with AMD realized the greatest benefit from laser treatment (RR, 1.82) and hypertensive patients experienced little or no benefit (RR, 0.93). Untreated eyes with ocular histoplasmosis were at much greater risk of a 6-line decrease in visual acuity from the 1-year through the 5-year examination than were treated eyes (unadjusted RR, 2.60; RR, 4.26 after adjustment for visual acuity and hypertension at baseline; P < .001 for both). The treatment effect for eyes with idiopathic choroidal neovascularization was between the effects for eyes with AMD and eyes with ocular histoplasmosis.
The early beneficial effects of laser treatment on visual acuity persisted for at least 5 years in eyes with all three underlying conditions. Laser treatment of similar eyes with choroidal neovascularization in a juxtafoveal location is recommended for patients with these conditions, with the caveat that hypertensive patients with AMD may fare no better with laser treatment than without treatment.
JournalArchives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 112 Issue 4 Pg. 500-9 (Apr 1994) ISSN: 0003-9950 [Print] UNITED STATES
PMID7512336 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)
  • Aged
  • Aged, 80 and over
  • Choroid (blood supply)
  • Female
  • Follow-Up Studies
  • Fovea Centralis (surgery)
  • Humans
  • Laser Coagulation
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neovascularization, Pathologic (etiology, surgery)
  • Prognosis
  • Recurrence
  • Vision Disorders (etiology, physiopathology)
  • Visual Acuity

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: