LASER TREATMENT OF CHOROIDAL NEOVASCULARIZATION IN PATIENTS WITH ANGIOID STREAKS

The benefit of laser photocoagulation to choroidal neovascularization secondary to angioid streaks remains controversial. To further expand our knowledge, we reviewed the records of 20 patients (24 eyes) with c lassic (well-defined) choroidal neovascularization secondary to angioi d streaks, who were treated with laser between 1982 and 1991 at the Re tinal Vascular Center of the Wilmer Institute. The choroidal neovascul arization was extrafoveal in 18 (75%), juxtafoveal in two, subfoveal i n three, and indeterminate in one eye. Seventeen of the 24 fellow eyes (71%) had a disciform scar or choroidal neovascularization, or both. Follow-up ranged from three months to nine years (mean, 3.5 years; med ian, two years). Lines of visual acuity change averaged -2.5 at three, -2.6 at six, -2.4 at 12, and -4.8 lines at 24 months. Choroidal neova scularization persisted in five of 24 eyes and recurred in nine of the remaining 19 eyes at risk. When the fellow eye had choroidal neovascu larization, scar, or bo.th, at the time of treatment, the rate of pers istence or recurrence was 65% vs 33% if the fellow eye had no choroida l neovascularization, scar, or both. An average of four lines of visua l acuity was lost when fellow eyes had choroidal neovascularization, s car, or both, vs one line when the fellow eye had no choroidal neovasc ularization or scar. Laser photocoagulation of choroidal neovasculariz ation in patients with angioid streaks can result in closure of the ch oroidal neovascularization and stabilization of visual acuity.