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Article
August 1991

Argon Laser Photocoagulation for Neovascular MaculopathyFive-Year Results From Randomized Clinical Trials

Author Affiliations

Prepared for the Macular Photocoagulation Study Group by Barbara S. Hawkins, MS; Dawn W. Blackhurst, MS; Andrew P. Schachat, MD; R. Joseph Olk, MD; Michael A. Novak, MD; and Maureen G. Maguire, PhD.

Arch Ophthalmol. 1991;109(8):1109-1114. doi:10.1001/archopht.1991.01080080069030
Abstract

• With completion of follow-up of all patients enrolled in three randomized clinical trials of argon laser photocoagulation of extrafoveal choroidal neovascular membranes secondary to senile (age-related) macular degeneration, ocular histoplasmosis, or idiopathic causes, the Macular Photocoagulation Study Group has demonstrated that laser treatment of such lesions is beneficial in preventing or delaying large losses of visual acuity for at least 5 years. In eyes with senile (age-related) macular degeneration as the underlying cause, the relative risk of losing six or more lines of visual acuity from the baseline level among untreated eyes (n = 117) compared with laser-treated eyes (n = 119) was 1.5 from 6 months through 5 years after entry (P =.001). In addition, after 5 years, untreated eyes had lost a mean of 7.1 lines of visual acuity, while laser-treated eyes had lost 5.2 lines. Recurrent neovascularization had been observed in 54% of laser-treated eyes by the end of the 5-year follow-up period. Among eyes with ocular histoplasmosis, untreated eyes (n = 130) had 3.6 times the risk of laser-treated eyes (n = 132) of losing six or more lines of visual acuity (P<.0001). Also, untreated eyes had lost a mean of 4.4 lines of visual acuity after 5 years, compared with only 0.9 lines lost by laser-treated eyes. Among laser-treated eyes, recurrent neovascularization had been observed in 26% by 5 years after enrollment. When the extrafoveal lesion was due to idiopathic causes, the relative risk of losing six or more lines of visual acuity from the baseline level among untreated eyes (n = 34) compared with laser-treated eyes (n = 33) was 2.3 (P =.04). The mean number of lines of visual acuity lost from baseline to the 5-year examination was 4.4 among untreated eyes and 2.7 among laser-treated eyes. Recurrent neovascularization was observed in 34% of laser-treated eyes during 5 years of follow-up. Thus, observations throughout 5 years of follow-up underscore the earlier recommendations from the Macular Photocoagulation Study Group that eyes with well-defined extrafoveal choroidal neovascular membranes secondary to senile macular degeneration, ocular histoplasmosis, and idiopathic causes be treated with argon laser photocoagulation.

References
1.
Macular Photocoagulation Study Group.  Argon laser photocoagulation for senile macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1982;100:912-918.Article
2.
Macular Photocoagulation Study Group.  Argon laser photocoagulation for ocular histoplasmosis: results of a randomized clinical trial . Arch Ophthalmol . 1983;101:1347-1357.Article
3.
Macular Photocoagulation Study Group.  Argon laser photocoagulation for idiopathic neovascularization: results of a randomized clinical trial . Arch Ophthalmol . 1983;101:1358-1361.Article
4.
Macular Photocoagulation Study Group.  Argon laser photocoagulation for neovascular maculopathy: three-year results from randomized clinical trials . Arch Ophthalmol . 1986;104:694-701.Article
5.
Macular Photocoagulation Study Group.  Recurrent choroidal neovascularization after argon laser photocoagulation for neovascular maculopathy . Arch Ophthalmol . 1986;104:503-512.Article
6.
Macular Photocoagulation Study Group. Manual of Procedures . Springfield, Va: National Technical Information Service; 1991: Accession No. PB91-159368.
7.
Macular Photocoagulation Study Group.  Changing the protocol: a case report from the Macular Photocoagulation Study . Controlled Clin Trials . 1984;5:203-216.Article
8.
Bailey IL, Lovie JE.  New design principles for visual acuity letter charts . Am J Optom Physiol Optic . 1976;53:740-745.Article
9.
Zeger SL, Liang KY.  Longitudinal data analysis for discrete and continuous outcomes . Biometrics . 1986;42:121-130.Article
10.
Snedecor GW, Cochran WG. Statistical Methods . 7th ed. Ames: Iowa State University Press; 1980:144-145.
11.
Snedecor GW, Cochran WG. Statistical Methods . 7th ed. Ames: Iowa State University Press; 1980:89-95.
12.
Kaplan EL, Meier P.  Nonparametric estimation from incomplete observations . J Am Stat Assoc . 1958;53:457-481.Article
13.
Bressler SB, Maguire MG, Bressler NM, Fine SL, Macular Photocoagulation Study Group.  Relationship of drusen and abnormalities of the retinal pigment epithelium to the prognosis of neovascular macular degeneration . Arch Ophthalmol . 1990;108:1442-1447.Article
14.
Folk JC, Blackhurst DW, Alexander J, et al. Pretreatment fundus characteristics as predictors of recurrent choroidal neovascularization. Arch Ophthalmol. In press.
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