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Cited by 61Retinal Diseases and TreatmentsOcular and Laser Science ResearchRetinal and Macular Surgery

Prophylactic treatment of age-related macular degeneration report number 1: 810-nanometer laser to eyes with drusen. Unilaterally eligible patients

Friberg, Thomas R., Musch, David C., Lim, Jennifer I., Morse, Larry, Freeman, William, Sinclair, Steven·2006·Ophthalmology
DOI 10.1016/j.ophtha.2005.10.066
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Abstract

Objective To determine the effects of subthreshold 810-nm-diode laser treatment on the rate of development of choroidal neovascularization (primary end point) and the effect on visual acuity (VA) in participants with multiple large drusen in one eye and a preexisting neovascular age-related macular degeneration (AMD) lesion in the other.Design Multicenter, prospective, randomized controlled trial.Participants Two hundred forty-four patients > or =50 years of age and with a neovascular or advanced AMD lesion in one eye and, in the fellow "study" eye, (1) at least 5 drusen > or = 63 mum in diameter, (2) Early Treatment Diabetic Retinopathy Study best-corrected VA (BCVA) of 20/63 or better, and (3) no evidence of neovascularization at baseline.Methods Patients were randomized to treatment or observation of their study eye at each of 22 centers. At each visit, the protocol specified that BCVA, a complete retinal examination, and fluorescein angiography be documented. Treated eyes had a grid of 48 extrafoveal, subthreshold diode (810 nm) laser spots, 125 mum in diameter, placed in an annulus outside of the foveola. Patients were seen at baseline and at 3, 6, 12, 18, 24, 30, and 36 months after randomization. No retreatments were allowed.Main outcome measures Development of choroidal neovascularization (as confirmed by fluorescein angiography) and change in BCVA.Results Throughout follow-up, the rate of choroidal neovascularization events in treated eyes consistently exceeded that in observed eyes. At 1 year, the difference was 15.8% versus 1.4% (P = 0.05). Most of the intergroup differences in choroidal neovascularization events occurred during the first 2 years of follow-up. Treated eyes showed a higher rate of VA loss (> or =3 lines) at 3- and 6-month follow-ups relative to observed eyes (8.3% vs. 1% and 11.4% vs. 4%, respectively; Ps = 0.02, 0.07). After 6 months, no significant differences were observed in VA loss between groups.Conclusion Prophylactic subthreshold 810-nm-diode laser treatment to an eye with multiple large drusen in a patient whose fellow eye has already suffered a neovascular event places the treated eye at higher risk of developing choroidal neovascularization. We advise against using prophylactic subthreshold diode laser treatment in these eyes.

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  • Laser treatment did seem to delay the development of choroidal neovascularisation by 6 months in studies that included patients with unilateral advanced age-related macular degeneration.

    “Laser treatment did seem to delay the development of choroidal neovascularisation by 6 months in studies that included patients with unilateral advanced age-related macular degeneration.157,158”

    From Age-related macular degeneration (2008) · cites this paper as [158]

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Authors
Friberg, T. R., Musch, D. C., Lim, J. I., Morse, L., Freeman, W., & Sinclair, S.
Affiliations
  • University of Pittsburgh (US)
  • University of Michigan (US)
  • University of Southern California (US)
  • University of California, Davis (US)
  • University of California San Diego (US)
  • Crozer-Keystone Health System (US)
Corresponding author
Friberg, Thomas R.
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
2006-04
Volume
113
Issue
4
Pages
612-622.e1
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/j.ophtha.2005.10.066
OpenAlex
W2128575831
Cited by
61
References
30
Citations by year
2025: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 5 · 2018: 7 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 5
FWCI
5.97
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Ophthalmology › Ocular and Laser Science Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
Keywords
age-related macular degeneration, choroidal neovascularization, subthreshold laser photocoagulation, 810 nm diode laser, drusen, prophylaxis, visual acuity loss, retinal pigment epithelium, macular pigment optical density
MeSH terms
Aged, Female, Fluorescein Angiography, Follow-Up Studies, Humans, Macula Lutea, Macular Degeneration, Male, Middle Aged, Prospective Studies, Risk Factors, Visual Acuity, Retinal Drusen, Laser Coagulation, Choroidal Neovascularization

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