We have located links that may give you full text access.
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.
Laser photocoagulation for juxtafoveal choroidal neovascularization. Five-year results from randomized clinical trials. Macular Photocoagulation Study Group.
Archives of Ophthalmology 1994 April
OBJECTIVE: To summarize findings from three randomized clinical trials of krypton laser treatment of juxtafoveal neovascular lesions regarding changes in visual acuity during 5 years of follow-up, rates of persistent and recurrent choroidal neovascularization, and status of macular lesions 5 years after enrollment. DESIGN, PATIENTS, AND PRIMARY OUTCOME MEASURES: Follow-up of patients enrolled in three randomized trials of choroidal neovascularization secondary to age-related macular degeneration (AMD), ocular histoplasmosis, or idiopathic causes ended in March 1991. All patients were eligible to complete at least 3 years of follow-up examinations. Data on visual acuity, reading vision, and anatomic outcomes during 5 years of follow-up were available for 276 (92%) of 300 patients with AMD, 236 (92%) of 256 patients with ocular histoplasmosis, and 38 (97%) of 39 patients with idiopathic choroidal neovascularization enrolled 5 or more years earlier who were still living.
RESULTS: Among eyes with AMD, the estimated relative risk (RR) of a loss of 6 or more lines of visual acuity from baseline to any examination from 6 months through 5 years after enrollment for untreated eyes in comparison with treated eyes was 1.20 (P = .04). Normotensive patients with AMD realized the greatest benefit from laser treatment (RR, 1.82) and hypertensive patients experienced little or no benefit (RR, 0.93). Untreated eyes with ocular histoplasmosis were at much greater risk of a 6-line decrease in visual acuity from the 1-year through the 5-year examination than were treated eyes (unadjusted RR, 2.60; RR, 4.26 after adjustment for visual acuity and hypertension at baseline; P < .001 for both). The treatment effect for eyes with idiopathic choroidal neovascularization was between the effects for eyes with AMD and eyes with ocular histoplasmosis.
CONCLUSIONS: The early beneficial effects of laser treatment on visual acuity persisted for at least 5 years in eyes with all three underlying conditions. Laser treatment of similar eyes with choroidal neovascularization in a juxtafoveal location is recommended for patients with these conditions, with the caveat that hypertensive patients with AMD may fare no better with laser treatment than without treatment.
RESULTS: Among eyes with AMD, the estimated relative risk (RR) of a loss of 6 or more lines of visual acuity from baseline to any examination from 6 months through 5 years after enrollment for untreated eyes in comparison with treated eyes was 1.20 (P = .04). Normotensive patients with AMD realized the greatest benefit from laser treatment (RR, 1.82) and hypertensive patients experienced little or no benefit (RR, 0.93). Untreated eyes with ocular histoplasmosis were at much greater risk of a 6-line decrease in visual acuity from the 1-year through the 5-year examination than were treated eyes (unadjusted RR, 2.60; RR, 4.26 after adjustment for visual acuity and hypertension at baseline; P < .001 for both). The treatment effect for eyes with idiopathic choroidal neovascularization was between the effects for eyes with AMD and eyes with ocular histoplasmosis.
CONCLUSIONS: The early beneficial effects of laser treatment on visual acuity persisted for at least 5 years in eyes with all three underlying conditions. Laser treatment of similar eyes with choroidal neovascularization in a juxtafoveal location is recommended for patients with these conditions, with the caveat that hypertensive patients with AMD may fare no better with laser treatment than without treatment.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app