Ic. Frennesson et Seg. Nilsson, EFFECTS OF ARGON (GREEN) LASER TREATMENT OF SOFT DRUSEN IN EARLY AGE-RELATED MACULOPATHY - A 6 MONTH PROSPECTIVE-STUDY, British journal of ophthalmology, 79(10), 1995, pp. 905-909
Aim-To evaluate whether perifoveal laser photocoagulation of soft drus
en reduces the total area occupied by drusen. Method-In a prospective,
randomised study, 20 patients (mean age 71.3 (SD 7.7) years) with ear
ly age-related maculopathy (ARM) in the form of soft drusen and pigmen
tary changes and with good visual acuity (0.94 (0.09)) were treated wi
th argon green laser photocoagulation. Mild laser bums (200 mu m) were
placed within a temporal horseshoe-shaped area, extending from a dist
ance of no less than 500 mu m from the centre of the fovea to the vasc
ular arcades. They were placed on the drusen and scattered over areas
where no drusen were present. Fundus colour photography and fluorescei
n angiography were performed at study entry as well as after 3 and 6 m
onths. Nineteen age-matched patients (68.5 (6.2) years) with soft drus
en maculopathy (visual acuity 0.95 (0.10)) were followed as a control
group. Using a computer system, the area occupied by drusen was determ
ined as a portion of the total area of a circle with a radius correspo
nding to 1250 mu m in the fundus for the angiograms and 2500 mu m for
the colour photographs, respectively. At study entry, the mean area oc
cupied by drusen in the treatment group was not significantly (p>0.5-0
.7) different from that of the control group. Results-The mean drusen
area of the angiograms and fundus colour photographs in the treated gr
oup decreased significantly from 19.3% to (p=0.002) and from 7.84% to
(p=0.005), respectively. In the untreated group, the mean area occupie
d by drusen increased significantly from 17.4% to 20.4% (p=0 030) and
from 8.33% to 9.23% (p=0.002), respectively. No significant changes in
visual acuity (p>0.05-0.5) or in visual fields (p>0.05-0.3) occurred
in either of the two groups during 6 months. Conclusion-The study sugg
ests that the area occupied by soft drusen in patients with early ARM
decreases after perifoveal laser photocoagulation but increases in an
untreated control group.