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Laser treatment in fellow eyes with large drusen: updated findings from a pilot randomized clinical trial.

Abstract：

PURPOSE:To update the findings from the Choroidal Neovascularization Prevention Trial (CNVPT) with respect to resolution of drusen, incidence of choroidal neovascularization, and visual function. DESIGN:A multicenter, randomized, controlled, pilot clinical trial. PARTICIPANTS:The 120 patients enrolled in the CNVPT. Patients had signs of choroidal neovascularization or retinal pigment epithelial detachment in 1 eye and had >/=10 large (>63- micro m) drusen in the contralateral, or fellow, eye. INTERVENTION:The fellow eye of 59 patients was assigned randomly to argon green laser treatment consisting of multiple 100- micro m spots at least 750 micro m from the center of the fovea. The fellow eye of the remaining 61 patients was assigned randomly to observation. MAIN OUTCOME MEASURES:Change in visual acuity was the primary outcome measure. Incidence of choroidal neovascularization, resolution of drusen, change in contrast threshold, change in critical print size for reading, and incidence of geographic atrophy were secondary outcome measures. RESULTS:Throughout 4 years of follow-up, there were no statistically significant differences in change in visual acuity, contrast threshold, critical print size, or incidence of geographic atrophy. With additional follow-up, the large increase in the incidence of choroidal neovascularization observed within 18 months of treatment was maintained; however, by 30 months, the incidence in the two treatment groups was the same. Most drusen resolution in treated eyes occurred within 24 months of the initial treatment. Treated eyes that received higher-intensity laser burns had an increased risk of choroidal neovascularization. Among eyes developing choroidal neovascularization in each treatment group, most lesions (two thirds or more) were composed of occult neovascularization only. CONCLUSIONS:Laser treatment as applied in the CNVPT caused an excess risk of choroidal neovascularization in the first year or so after treatment. The increased early incidence of choroidal neovascularization was not associated with either a harmful or beneficial effect in this pilot study.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Choroidal Neovascularization Prevention Trial Research Group.

doi

10.1016/S0161-6420(03)00098-8

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

971-8

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(03)00098-8

journal_volume

110

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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Laser treatment in fellow eyes with large drusen: updated findings from a pilot randomized clinical trial.