Treatment of age‐related macular degeneration by laser photocoagulation

Abstract

Laser treatment with blue‐green argon, green argon and/or krypton red was performed on 578 eyes in 443 patients with neovascular age‐related macular degeneration (AMD). The visual acuity was examined in all eyes 2 to 8 weeks after initial treatment and in 204 eyes in 167 patients 2 to 4 years after initial treatment. The short term results were as follow: 91/578 eyes (16%) had improved ( 2 lines on Snellen's chart or equivalent steps), 445/578 eyes (77%) remained unchanged and 42/578 eyes (7%) had deteriorated visual acuity ( 2 lines on Snellen's chart or equivalent steps). The reduction in visual acuity, may in about half of the 42 eyes be caused by too intensive laser application in the beginning of this study in 1983 and 1984 where treatment was applied with blue‐green argon, which has now been abandoned. In the group with an observation time of 2 to 4 years, 42/204 eyes (21%) had improved, 119/204 eyes (58%) remained unchaged and 43/204 eyes (21%) had a deteriorated visual acuity. In the 204 eyes the subretinal neovascular lesion(s) were located extrafoveally in 52 eyes, juxtafoveally in 114 eyes and subfoveally in 38 eyes. It is to be pointed out, that even patients with a pre‐laser visual acuity of 6/60 or worse obtained an improvement of visual acuity in 12/27 eyes. About 40% of the eyes needed re‐treatment from 1 to 8 times. It is unknown whether the obtained results are to be considered marginal or more substantial. Reports from abroad indicate that about 75% of eyes with neovascular AMD go blind within one to two years. Controlled long term clinical studies are required of the natural history and of the post‐laser course. ‐

Primary success with low vision aids in age‐related macular degeneration

“…Many simple magnifiers in any case had a build-in illuminator. nal neovascular membrane and reduce the scotoma caused by central scar (Moorfield Macular Study Group 1982;Macular Photocoagulation Study Group 1982;Nielsen et al 1988). If the disciform process is too advanced for laser treatment, or if the treatment has been unsuccessful, and in eyes with atrophic degeneration, attention has to be directed to the utilization of the residual visual acuity and the peripheral visual field.…”

“…ation may benefit from laser treatment. Photocoagulation may arrest the growth of the subreti- Nielsen et al 1988). If the disciform process is too advanced for laser treatment, or if the treatment has been unsuccessful, and in eyes with atrophic degeneration, attention has to be directed to the utilization of the residual visual acuity and the peripheral visual field.…”