I commend the Macular Photocoagulation Study Group1 on their refinement of treatment recommendations for patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration. I would suggest, however, a somewhat different interpretation of the results obtained in their group B patients (patients with small lesions and visual acuity of 20/100 or better or with medium lesions and visual acuity of 20/160 or better). They state that "Eyes in group B... have a substantial treatment benefit beginning 1 year after treatment and are good candidates for immediate treatment," a statement that I believe is misleading.
In their report, the authors implicitly equate treatment benefit with visual acuity at a particular time. This is a significant oversimplification of the true benefit or lack of benefit of therapy. Consider two identical patients qualifying for inclusion in group B. The first patient is treated with laser therapy and the second patient is
Tiedeman JS. Treatment of Subfoveal Choroidal Neovascularization. Arch Ophthalmol. 1995;113(2):137–138. doi:10.1001/archopht.1995.01100020015009
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