Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial

Maureen G. Maguire, Paul Sternberg, Thomas M. Aaberg, Daniel Martin, David Saperstein, Maureen Hyatt, James Gilman, Ray Swords, Gabriela Nemes, Lawrence J. Singerman, Thomas A. Rice, Hernando Zegarra, Michael A. Novak, Scott Pendergast, Z. Nicholas Zakov, John Niffenegger, Michelle Bartel, Susan Lichterman, Donna Knight, Kim Tilocco-DuBoisMary Ilk, Geraldine Daley, Gregg Greanoff, John DuBois, Diane Weiss, Alice Lyon, Lee Jampol, David Weinberg, Beth Chiapetta, Zuzanna Strugala, Len Richine, Gary Edd Fish, David Callanan, Bradley Jost, Rajiv Anand, William B. Snyder, Dwain Fuller, Theresa Anderson, Sally Arceneaux, Hank Aguado, Cynthia Nork, Bob Boleman, Penny Avery, Sue Solomon, John King, David Orth, Kirk Packo, Jack Cohen, Serge DeBustros, Celeste Figliulo, Chris Morrison, Katherine Lluen-Johnson, Douglas Bryant, Don Doherty, James Folk, H. Culver Boldt, Karen Gehrs, Stephen Russell, Connie Fountain, Marcia Griffin, Ed Heffron, Carolyn Vogel, Bill Ward, Ray Northway, Felix Sabates, Ron Schuchard, Nelson Sabates, Abraham Poulose, Vicki Crosser, Camille Matta, Mickie Keeling, Hong Lei, Gary Gallimore, Eric R. Holz, William Wood, Rick Isernhagen, Jenny Wolfe, Lisa Hawkins, Yvonne Taul, Mary Oldroyd, Leslie Cornett, Jeanne Van Arsdall, Edward Slade, Melanie Harris, Suresh Chandra, Thomas Stevens, Frank Meyers, Timothy Olsen, Barbara Blodi, Justin Gottlieb, Wendy Walker, Jennie Perry, Gene Knutson, Robert Harrison, Michael Neider, Hugh Wabers, Hunter Little, Mark Blumenkranz, Robert Jack

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Purpose: To update the findings from the Choroidal Neovascularization Prevention Trial (CNVPT) with respect to resolution of drusen, incidence of choroidal neovascularization, and visual function. Design: A multicenter, randomized, controlled, pilot clinical trial. Participants: The 120 patients enrolled in the CNVPT. Patients had signs of choroidal neovascularization or retinal pigment epithelial detachment in 1 eye and had ≥10 large (>63-μm) drusen in the contralateral, or fellow, eye. Intervention: The fellow eye of 59 patients was assigned randomly to argon green laser treatment consisting of multiple 100-μm spots at least 750 μm from the center of the fovea. The fellow eye of the remaining 61 patients was assigned randomly to observation. Main Outcome Measures: Change in visual acuity was the primary outcome measure. Incidence of choroidal neovascularization, resolution of drusen, change in contrast threshold, change in critical print size for reading, and incidence of geographic atrophy were secondary outcome measures. Results: Throughout 4 years of follow-up, there were no statistically significant differences in change in visual acuity, contrast threshold, critical print size, or incidence of geographic atrophy. With additional follow-up, the large increase in the incidence of choroidal neovascularization observed within 18 months of treatment was maintained; however, by 30 months, the incidence in the two treatment groups was the same. Most drusen resolution in treated eyes occurred within 24 months of the initial treatment. Treated eyes that received higher-intensity laser burns had an increased risk of choroidal neovascularization. Among eyes developing choroidal neovascularization in each treatment group, most lesions (two thirds or more) were composed of occult neovascularization only. Conclusions: Laser treatment as applied in the CNVPT caused an excess risk of choroidal neovascularization in the first year or so after treatment. The increased early incidence of choroidal neovascularization was not associated with either a harmful or beneficial effect in this pilot study.

Original languageEnglish (US)
Pages (from-to)971-978
Number of pages8
JournalOphthalmology
Volume110
Issue number5
DOIs
StatePublished - May 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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    Maguire, M. G., Sternberg, P., Aaberg, T. M., Martin, D., Saperstein, D., Hyatt, M., Gilman, J., Swords, R., Nemes, G., Singerman, L. J., Rice, T. A., Zegarra, H., Novak, M. A., Pendergast, S., Zakov, Z. N., Niffenegger, J., Bartel, M., Lichterman, S., Knight, D., ... Jack, R. (2003). Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial. Ophthalmology, 110(5), 971-978. https://doi.org/10.1016/S0161-6420(03)00098-8