PROPHYLACTIC LASER TREATMENT TO FELLOW EYES OF UNILATERAL RETINAL-PIGMENT EPITHELIAL TEARS

PURPOSE: To evaluate prophylactic laser treatment of the macula in red ucing the risk of visual loss in the fellow eye of patients with a ret inal pigment epithelial tear caused by age-related macular degeneratio n in the first eye. METHODS: In a prospective study, 12 patients with a retinal pigment epithelial tear in one eye caused by age-related mac ular degeneration an drusen in the fellow eye received prophylactic la ser treatment of the retina in their fellow eyes and were followed up for 2 years or more after prophylactic treatment. RESULTS: In 12 fello w eyes that received prophylactic laser treatment, a reduction in best -corrected visual acuity to 20/80 or worse occurred in one (8%) of 12 eyes in the first year and two (18%) of the remaining Il eyes in the s econd year after treatment. The cumulative risk of visual loss in the treated fellow eye was 25% in 2 years. CONCLUSIONS: In historical cont rol subjects in a natural history study of patients with retinal pigme nt epithelial tear in one eye, central visual loss occurred in 16 (37% ) of 43 eyes in the first year and in seven (30%) of 23 eyes in the se cond year for a cumulative loss of 59% in the first 2 years. Compared with these historical control subjects, our findings suggest that visu al loss in the fellow eyes of patients with a retinal pigment epitheli al tear in the first eye is reduced by prophylactic low intensity lase r photocoagulation of the macula. (C) 1998 by Elsevier Science Inc, Al l rights reserved.