LASER PHOTOCOAGULATION FOR NEOVASCULAR LESIONS NASAL TO THE FOVEA - RESULTS FROM CLINICAL-TRIALS FOR LESIONS SECONDARY TO OCULAR HISTOPLASMOSIS OR IDIOPATHIC CAUSES

Objective: To determine whether laser photocoagulation of peripapillar y choroidal neovascularization (CNV) or large neovascular lesions that are located nasal to the fovea is beneficial with respect to preserva tion of remaining vision-consistent with the overall study findings. P atients and interventions: A total of 113 eyes (112 patients) having e ither peripapillary CNV or CNV that was located nasal to the fovea and larger than 750 mu m in longest diameter associated with either ocula r histoplasmosis or idiopathic causes were identified from the eyes th at were randomly assigned to either laser photocoagulation or observat ion only in clinical trials conducted by the Macular Photocoagulation Study Group. Main Outcome Measures: Visual acuity and change in visual acuity from baseline examination were compared for laser-treated and untreated eyes. Results: At the 3-year examination, 11% (6/54) of the treated eyes vs 41% (21/51) of the untreated eyes had lost six or more lines of visual acuity (P<.001). Among eyes with peripapillary lesion s, 14% (3/22) of the treated eyes vs 26% (6/23) of the untreated eyes had lost six or more lines of visual acuity at the 3-year examination (P=.29), Among eyes with nasal lesions, 9% (3/32) of the treated eyes vs 54% (15/28) of the untreated eyes had lost six or more lines of vis ual acuity at the 3-year examination (P<.001). Conclusion: Results fro m the subset of patients who had extrafoveal or juxtafoveal peripapill ary CNV or CNV that was located nasal to the fovea were consistent wit h the beneficial results of treatment observed in the entire group of eyes that were studied by the Macular Photocoagulation Study Group.