LASER PHOTOCOAGULATION FOR MACULAR SOFT DRUSEN - UPDATED RESULTS

Purpose: To update the results of a study on the disappearance of macu lar soft drusen after laser treatment in the natural evolution of age- related macular degeneration. Methods: A total of 46 patients with con fluent soft drusen and pigmentary changes were studied prospectively. Group 1 was composed of 30 patients with bilateral drusen; the authors randomly assigned one eye of each patient for treatment and the fello w eye for the control. In 16 patients a choroidal neovascular membrane was present in one eye, and treatment was applied to the fellow eye ( group 2). Argon green laser treatment was applied directly to the soft drusen in the temporal macula. Results: All treated drusen disappeare d in a mean of 3.5 months after treatment, and untreated drusen disapp eared in all but three patients in an average of 8.5 months. After an average period of 3 years, only one control eye and none of the treate d eyes in group 1 developed a choroidal neovascular membrane (P = 0.50 0). In group 2, neovascularization occurred in 18% of the patients. Th e initial improvement in Snellen acuity after subfoveal drusen disappe arance diminished as a consequence of cataract progression. Conclusion s: Although no definitive conclusions should be made because of the sm all number of patients studied, results seem to show that this treatme nt does not reduce the risk of choroidal neovascularization in the tre ated eye of patients with a history of exudative disease in the fellow eye. It may be effective in patients with high-risk bilateral soft dr usen, that is, in less advanced stages of the disease.