To the Editor.
—The mechanism of regression of intraocular neovascularization has recently been debated in the May and December 1988 issues of the Archives.1,2 I would like to point out one feature of central nervous system energy metabolism that, to my knowledge, has been largely overlooked in our theories regarding this important process. In the central nervous system, a very large part of metabolic energy is spent in the maintenance and restoration of neuronal membrane potentials.3,4 As a result, neural tissue consumes a lot more energy and oxygen when it is transmitting neural impulses. If a similar situation existed in the inner retina, one would expect a marked decrease in the energy requirements of the inner retina following photocoagulation because of the decreased synaptic input from the partially destroyed outer retina. It is quite possible that reduced synaptic transmission through the inner retina after photocoagulation improves the oxygen
Wilson DJ. Intraocular Neovascularization and Retinal Energy Metabolism. Arch Ophthalmol. 1989;107(7):953. doi:10.1001/archopht.1989.01070020015005