Abstract • Results from the Macular Photocoagulation Study Group have shown that argon laser photocoagulation is beneficial in reducing the risk of severe visual loss in eyes with extrafoveal choroidal neovascular membranes secondary to senile macular degeneration (Senile Macular Degeneration Study or SMDS), ocular histoplasmosis (Ocular Histoplasmosis Study or OHS), or idiopathic neovascularization (Idiopathic Neovascularization Study or INVS). However, argon laser treatment has not been entirely successful in permanently eradicating active neovascularization from those eyes. Recurrent neovascularization in the form of either neovascularization contiguous with the treatment scar or independent neovascular membranes have been observed in 70 (59%) of the 119 SMDS eyes originally assigned to treatment, 40 (30%) of the 132 OHS eyes, and 11 (33%) of the 33 INVS eyes. Recurrence was accompanied by an increased frequency of severe visual loss. Characteristics of the patient, original lesion, and treatment were examined for their ability to predict recurrence. Cigarette smoking was related to the rate of recurrence in the SMDS (P =.02) and the INVS (P =.09). Younger age and female gender were associated with an increased frequency of recurrence in the OHS. Predictions of which eyes will suffer recurrence, however, cannot be made accurately. Therefore, careful follow-up of all treated eyes is indicated, particularly within the first year after initial argon photocoagulation. References 1. Macular Photocoagulation Study Group: Argon laser photocoagulation for senile macular degeneration: Results of a randomized clinical trial . Arch Ophthalmol 1982;100:912-918.Crossref 2. Moorfields Macular Study Group: Treatment of senile disciform macular degeneration: A single-blind randomized trial by argon laser photocoagulation . Br J Ophthalmol 1983;60:745-752. 3. Coscas G, Soubrane G: Photocoagulation des néovaisseaux sousretiniens dans la dégénerescence maculaire sénile par le laser a argon: Résultats de l'etude randomisée de 60 cas . Bull Soc Ophtalmol Fr 1982;88:102-106. 4. Macular Photocoagulation Study Group: Argon laser photocoagulation for neovascular maculopathy: Three-year results from randomized clinical trials. Arch Ophthalmol, in press. 5. Macular Photocoagulation Study Group: Argon laser photocoagulation for ocular.histoplasmosis: Results of a randomized clinical trial . Arch Ophthalmol 1983;101:1347-1357.Crossref 6. Macular Photocoagulation Study Group: Argon laser photocoagulation for idiopathic neovascularization: Results of a randomized clinical trial . Arch Ophthalmol 1983;101:1358-1361.Crossref 7. Olk RJ, Fine SL, Scheraga D, et al: Long-term follow-up of ocular histoplasmosis treated by argon laser photocoagulation . Retina 1981;1:238-244.Crossref 8. Sorenson JA, Yannuzzi LA, Shakin JL: Recurrent subretinal neovascularization . Ophthalmology 1985;92:1059-1075.Crossref 9. Soubrane G, Coscas G, Baudouin C, et al: Long-term follow-up of the randomized argon blue-green trial in senile macular degeneration. Presented at the 14th meeting of the Jules Gonin Club, Lausanne, Switzerland, September 1984. 10. Kaplan EL, Meier P: Nonparametric estimation from incomplete observations . J Am Stat Assoc 1958;53:457-481.Crossref 11. Mantel N: Evaluation of survival data and two new rank order statistics arising in its consideration . Cancer Chemother Rep 1966;50:163-170. 12. Cox DR: Regression models and life tables . J R Stat Soc B 1972;2:187-220. 13. Bressler SB, Bressler NM, Fine SL, et al: Subfoveal neovascular membranes in senile macular degeneration: Relationship between membrane size and visual prognosis . Retina 1983;3:7-11.Crossref 14. Hyman LG, Lilienfeld AM, Ferris FL III, et al: Senile macular degeneration: A case-control study . Am J Epidemiol 1983;118:213-227. 15. Paetkau ME, Boyd TA, Grace M, et al: Senile disciform macular degeneration and smoking . Can J Ophthalmol 1978;13:67-71. 16. Kini MM, Leibowitz HM, Colton T, et al: Prevalence of senile cataract, diabetic retinopathy, senile macular degeneration, and open angle glaucoma in the Framingham Eye Study . Am J Ophthalmol 1978;85:28-34. 17. Ganley JP: Epidemiologic characteristics of presumed ocular histoplasmosis . Acta Ophthalmol 1973; (suppl 119) , pp 1-63. 18. Friedman E: Choroidal blood flow . Arch Ophthalmol 1970; 83:95-99.Crossref 19. Bettman JW, Fellows V, Chao P: The effect of cigarette smoking on the intraocular circulation . Arch Ophthalmol 1958; 59:481-483.Crossref 20. Hammond EC: Smoking in relation to the death rates of 1 million men and women , in Haenszel W (ed): Epidemiological Approaches to the Study of Cancer and Other Diseases . Bethesda, Md, US Public Health Service, National Cancer Institute Monograph No. 19, January 1966, pp 127-204.
Archives of Ophthalmology – American Medical Association
Published: Apr 1, 1986
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