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Article
September 1993

Laser Photocoagulation of Subfoveal Neovascular Lesions of Age-Related Macular DegenerationUpdated Findings From Two Clinical Trials

Author Affiliations

Prepared for the Macular Photocoagulation Study (MPS) Group by Barbara S. Hawkins, PhD, and Stuart L. Fine, MD. A complete list of the participants of the MPS Group as of July 3, 1990, appeared on page 1231 of the September 1991 issue of the Archives. Martha J. Marsh, MS, joined the MPS Coordinating Center Staff in January 1992.; No member of the MPS Group has any proprietary interest in development or marketing of any commercially available products used in these or any other MPS clinical trials.

Arch Ophthalmol. 1993;111(9):1200-1209. doi:10.1001/archopht.1993.01090090052019
Abstract

Objective:  To report 3- and 4-year visual outcomes in eyes followed up in two randomized clinical trials of laser photocoagulation for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration.

Design and Main Outcome Measures:  Eyes of consenting patients were assigned randomly to laser treatment or no treatment. Visual acuity, reading speed, and contrast threshold were measured before random assignment, 3 and 6 months later, and at 6-month intervals thereafter. Visual acuities of treated and untreated eyes were compared 4 years after enrollment, in the Subfoveal New CNV Study (eyes without prior laser treatment), and 3 years after enrollment, in the Subfoveal Recurrent CNV Study (eyes with subfoveal recurrent CNV at the periphery of an earlier laser treatment scar).

Results:  Four years after enrollment in the Subfoveal New CNV Study, 39 (47%) of 83 untreated eyes and 17 (22%) of 77 laser-treated eyes had lost 6 or more lines of visual acuity from baseline levels (P=.002). At the 3-year examination in the Subfoveal Recurrent CNV Study, 21 (36%) of 58 untreated eyes and six (12%) of 49 treated eyes had lost 6 or more lines of visual acuity from baseline levels (P=.009). Comparisons based on contrast threshold and reading speed for enlarged text also favored laser treatment in both trials.

Conclusions:  Stronger evidence favoring laser photocoagulation of subfoveal CNV has been provided by continued follow-up of patients enrolled in these two clinical trials. The benefits of laser treatment have persisted through at least 4 years of follow-up in the Subfoveal New CNV Study and 3 years of follow-up in the Subfoveal Recurrent CNV Study.

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