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—Drs Tornambe and Poliner raise interesting questions about the treatment strategy for NVMs within the foveal avascular zone. However, we do not believe that "treatment inside the foveal vascular zone remains a dilemma." Results in our initial report on the effectiveness of krypton laser photocoagulation in preventing loss of vision1 showed that among eyes with neovascularization within 200 μm of the foveal center, 8% of treated eyes in comparison with 32% of untreated eyes had large losses in visual acuity (≥ 6 lines).While intentional partial treatment of the neovascularization to spare receptors within the foveal avascular zone is appealing, we have misgivings about the strategy. The proposed partial treatment is far less extensive than treatment applied to eyes that were not completely covered in the Krypton Ocular Histoplasmosis Study. Subsequent persistent leakage from the NVM and its vision-threatening effects may overwhelm the benefit of sparing some
Maguire MG, Folk JC, Singerman LJ, Schachat AP, Blackhurst DW, Chamberlin JA, Bressler NM, Fine SL, Hawkins BS, Elman MJ. Partial Ablation of Neovascular Membranes Involving the Fovea-Reply. Arch Ophthalmol. 1989;107(7):956. doi:10.1001/archopht.1989.01070020017010