Prophylactic Treatment of Age-Related Macular Degeneration Report Number 2: 810-Nanometer Laser to Eyes With Drusen: Bilaterally Eligible Patients
Prophylactic Treatment of Age-Related Macular Degeneration Report Number 2: 810-Nanometer Laser to Eyes With Drusen: Bilaterally Eligible Patients
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DOI：
10.3928/15428877-20091030-01
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发表时间：
2009-11-01
影响因子：
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通讯作者：
Musch, David C.
中科院分区：
文献类型：
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作者：
Friberg, Thomas R.;Brennen, Peter M.;Musch, David C.
背景和目的：探讨单次阈值下810纳米激光对双眼干性老年性黄斑变性的预防和治疗价值。方法：老年性黄斑变性的预防治疗研究共纳入639名年龄在50岁以上、每只眼直径至少为5只玻璃体63 pm或以上的1278只眼。治疗包括放置48个黄斑中心凹外的环形栅格，阈值下810 nm半导体激光照射，以每位参与者的一只眼为中心但保留中心凹，另一只眼作为对照。比较治疗眼与未治疗眼脉络膜新生血管的发展及最佳矫正视力的变化。结果：阈值以下激光治疗不降低治疗眼与未治疗眼的脉络膜新生血管的发生率。治疗眼在24个月时有适度的视力改善(1.5个字母差；P=0.04)，基线视力在20/32到20/63之间的参与者的治疗眼(4.0个字母差；P=0.0034)。结论：单次阈值下810纳米激光治疗双眼高危玻璃体不是预防脉络膜新生血管的有效方法。
BACKGROUND AND OBJECTIVE: To determine the prophylactic and therapeutic value of a single subthreshold 810-nanometer laser treatment in patients with high risk drusen as a manifestation of dry age-related macular degeneration in both eyes.PATIENTS AND METHODS: The Prophylactic Treatment of Age-related Macular Degeneration study enrolled 1,278 eyes of 639 participants who were 50 years or older with at least 5 drusen 63 pm or more in diameter in each eye. Treatment consisted of the placement of an annular grid of 48 extrafoveal, subthreshold 810-nm diode laser applications centered at but sparing the foveola in one eye of each participant, with the fellow eye serving as a control. Development of choroidal neovascularization and change in best-corrected visual acuity were compared between treated and untreated eyes.RESULTS: Subthreshold laser treatment did not decrease the incidence of choroidal neovascularization in treated versus untreated eyes. A modest visual a acuity benefit in treated eyes was found at 24 months (1.5 letter difference; P = .04) and in the treated eyes of participants with a baseline visual acuity between 20/32 and 20/63 (4.0 letter difference; P = .0034). However, this treatment effect was not sustained at 3 years.CONCLUSION: A single subthreshold 810-nanometer laser treatment to eyes of participants with bilateral high risk drusen is not an effective prophylactic strategy against choroidal neovascularization.