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August 1984

Macular Photocoagulation

Author Affiliations

Kansas City, Mo

Arch Ophthalmol. 1984;102(8):1120. doi:10.1001/archopht.1984.01040030902003

To the Editor.  —We were very pleased that the macular photocoagulation study1 in the September Archives corroborated our long-standing conviction, based on more than 400 cases treated in the last seven years, that photocoagulation, when adequately applied to the subretinal neovascular membrane of ocular histoplasmosis, is effective. However, we are disappointed in the following areas:

  1. Time of treatment as a factor was not considered in the evaluation of the results. Perhaps the small number of cases entered in the study prevented obtaining a significant statistical analysis of this factor. Having practiced in histoplasmosis endemic area for the past 23 years, we have been most impressed with the poor prognosis directly related to the delays in the application of laser therapy.2,3

  2. The role of steroid therapy was not evaluated. In our experience, once the active subretinal membrane has developed steroid treatment is of no value. We frequently continue to observe

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