Laser treatment in eyes with large Drusen: Short-term effects seen in a pilot randomized clinical trial

P. Sternberg, A. Capone, T. M. Aaberg, M. Hyatt, J. Gilman, R. Swords, L. Singerman, T. A. Rice, H. Zegarra, M. A. Novak, S. Lichterman, D. Knight, K. Tilocco, M. Elk, G. Daley, G. Greanoff, J. Dubois, A. Lyon, L. Jampol, D. WeinbergB. Chiapetta, Z. Strugala, L. Richine, G. E. Fish, D. Callanan, T. Anderson, S. Arceneaux, H. Aguado, C. Nork, B. Boleman, P. Avery, S. Solomon, D. Orth, C. Macleod, C. Morrison, K. Lluen-Johnson, D. Bryant, D. Doherty, J. Folk, C. Boldt, C. Fountain, M. Griffin, E. Heffron, C. Vogel, B. Ward, R. Northway, F. Sabates, R. Schuchard, N. Sabates, A. Poulose, V. Crosser, C. Matta, G. Gallimore, E. R. Holz, W. Wood, J. Wolfe, L. Hawkins, Y. Taul, M. Oldroyd, L. Cornett, J. Van Arsdall, E. Slade, M. Harris, S. Chandra, T. Stevens, F. Meyers, T. Olsen, W. Walker, G. Knutson, R. Harrison, M. Neider, H. Wabers, H. Little, M. Blumenkranz, J. Showman, T. Hahn, L. Jimenez, P. Matio, K. Gitter, G. Cohen, K. Newell, R. Ross, K. Schomaker, S. L. Fine, A. Brucker, A. C. Ho, A. Maguire, J. Grunwald, J. Dupont, J. Kirschner, E. Sterling, M. Sheehan, B. Nyberg, L. Weeney, J. Reynolds, D. Elkins, Michael Klein, David Wilson, S. Nolte

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Objective: This study aimed to describe the short-term effects of low- intensity laser treatment in eyes with drusen at risk of having choroidal neovascularization (CNV) develop secondary to age-related macular degeneration. Design: The study design was a multicentered, randomized clinical trial of laser treatment versus observation. Participants: One hundred fifty-six patients without exudative age-related macular degeneration and with more than 10 large (>63 μm) drusen in each eye were enrolled in the Bilateral Drusen Study. One hundred twenty patients with exudative age- related macular degeneration in I eye and more than 10 large drusen in the other eye were enrolled in the Fellow Eye Study. Intervention: The treatment protocol for most (85%) of the eyes consisted of 20 laser burns, 100 μm in diameter, in a pattern of 3 rows placed between the 12- and 6-o'clock positions beyond the temporal perimeter of the foveal avascular zone. The desired intensity of the bums was a gray-white lesion. Whenever the area of drusen had not been reduced by 50% or more at 6 months, a second treatment was applied nasal to the fovea in a mirror image of the first treatment. During the last 6 months of enrollment, a second laser treatment protocol was adopted that specified 24 laser burns, 100 μm in diameter, in a circular pattern of 2 rows surrounding the macular drusen. Main Outcome Measures: Change in visual acuity is the primary outcome measure. Incidence of CNV, change in contrast threshold, and change in critical print size are secondary outcome measures. Results: In the Bilateral Drusen Study, CNV developed in 4 of 156 treated eyes and in 2 of 156 observed eyes (P = 0.62); in the Fellow Eye Study, the proportions are 10/59 treated eyes and 2/61 observed eyes (P = 0.02). Changes in visual acuity are similar in treated and observed eyes in the Bilateral Drusen Study through 18 months. However, by 18 months, observed eyes in the Fellow Eye Study have lost more visual acuity than treated eyes (P = 0.02). Changes in contrast threshold are similar in treated and observed eyes in each study. Conclusions: Laser treatment to high-risk fellow eyes may increase the short-term incidence of CNV. Long-term effects in fellow eyes and effects in patients with bilateral drusen require additional observation.

Original languageEnglish (US)
Pages (from-to)11-23
Number of pages13
JournalOphthalmology
Volume105
Issue number1
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Lasers
Randomized Controlled Trials
Choroidal Neovascularization
Therapeutics
Macular Degeneration
Visual Acuity
Outcome Assessment (Health Care)
Clinical Protocols
Burns
Observation
Incidence
Nose

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Sternberg, P., Capone, A., Aaberg, T. M., Hyatt, M., Gilman, J., Swords, R., ... Nolte, S. (1998). Laser treatment in eyes with large Drusen: Short-term effects seen in a pilot randomized clinical trial. Ophthalmology, 105(1), 11-23. https://doi.org/10.1016/S0161-6420(98)90931-9

Laser treatment in eyes with large Drusen : Short-term effects seen in a pilot randomized clinical trial. / Sternberg, P.; Capone, A.; Aaberg, T. M.; Hyatt, M.; Gilman, J.; Swords, R.; Singerman, L.; Rice, T. A.; Zegarra, H.; Novak, M. A.; Lichterman, S.; Knight, D.; Tilocco, K.; Elk, M.; Daley, G.; Greanoff, G.; Dubois, J.; Lyon, A.; Jampol, L.; Weinberg, D.; Chiapetta, B.; Strugala, Z.; Richine, L.; Fish, G. E.; Callanan, D.; Anderson, T.; Arceneaux, S.; Aguado, H.; Nork, C.; Boleman, B.; Avery, P.; Solomon, S.; Orth, D.; Macleod, C.; Morrison, C.; Lluen-Johnson, K.; Bryant, D.; Doherty, D.; Folk, J.; Boldt, C.; Fountain, C.; Griffin, M.; Heffron, E.; Vogel, C.; Ward, B.; Northway, R.; Sabates, F.; Schuchard, R.; Sabates, N.; Poulose, A.; Crosser, V.; Matta, C.; Gallimore, G.; Holz, E. R.; Wood, W.; Wolfe, J.; Hawkins, L.; Taul, Y.; Oldroyd, M.; Cornett, L.; Van Arsdall, J.; Slade, E.; Harris, M.; Chandra, S.; Stevens, T.; Meyers, F.; Olsen, T.; Walker, W.; Knutson, G.; Harrison, R.; Neider, M.; Wabers, H.; Little, H.; Blumenkranz, M.; Showman, J.; Hahn, T.; Jimenez, L.; Matio, P.; Gitter, K.; Cohen, G.; Newell, K.; Ross, R.; Schomaker, K.; Fine, S. L.; Brucker, A.; Ho, A. C.; Maguire, A.; Grunwald, J.; Dupont, J.; Kirschner, J.; Sterling, E.; Sheehan, M.; Nyberg, B.; Weeney, L.; Reynolds, J.; Elkins, D.; Klein, Michael; Wilson, David; Nolte, S.

In: Ophthalmology, Vol. 105, No. 1, 1998, p. 11-23.

Research output: Contribution to journalArticle

Sternberg, P, Capone, A, Aaberg, TM, Hyatt, M, Gilman, J, Swords, R, Singerman, L, Rice, TA, Zegarra, H, Novak, MA, Lichterman, S, Knight, D, Tilocco, K, Elk, M, Daley, G, Greanoff, G, Dubois, J, Lyon, A, Jampol, L, Weinberg, D, Chiapetta, B, Strugala, Z, Richine, L, Fish, GE, Callanan, D, Anderson, T, Arceneaux, S, Aguado, H, Nork, C, Boleman, B, Avery, P, Solomon, S, Orth, D, Macleod, C, Morrison, C, Lluen-Johnson, K, Bryant, D, Doherty, D, Folk, J, Boldt, C, Fountain, C, Griffin, M, Heffron, E, Vogel, C, Ward, B, Northway, R, Sabates, F, Schuchard, R, Sabates, N, Poulose, A, Crosser, V, Matta, C, Gallimore, G, Holz, ER, Wood, W, Wolfe, J, Hawkins, L, Taul, Y, Oldroyd, M, Cornett, L, Van Arsdall, J, Slade, E, Harris, M, Chandra, S, Stevens, T, Meyers, F, Olsen, T, Walker, W, Knutson, G, Harrison, R, Neider, M, Wabers, H, Little, H, Blumenkranz, M, Showman, J, Hahn, T, Jimenez, L, Matio, P, Gitter, K, Cohen, G, Newell, K, Ross, R, Schomaker, K, Fine, SL, Brucker, A, Ho, AC, Maguire, A, Grunwald, J, Dupont, J, Kirschner, J, Sterling, E, Sheehan, M, Nyberg, B, Weeney, L, Reynolds, J, Elkins, D, Klein, M, Wilson, D & Nolte, S 1998, 'Laser treatment in eyes with large Drusen: Short-term effects seen in a pilot randomized clinical trial', Ophthalmology, vol. 105, no. 1, pp. 11-23. https://doi.org/10.1016/S0161-6420(98)90931-9
Sternberg, P. ; Capone, A. ; Aaberg, T. M. ; Hyatt, M. ; Gilman, J. ; Swords, R. ; Singerman, L. ; Rice, T. A. ; Zegarra, H. ; Novak, M. A. ; Lichterman, S. ; Knight, D. ; Tilocco, K. ; Elk, M. ; Daley, G. ; Greanoff, G. ; Dubois, J. ; Lyon, A. ; Jampol, L. ; Weinberg, D. ; Chiapetta, B. ; Strugala, Z. ; Richine, L. ; Fish, G. E. ; Callanan, D. ; Anderson, T. ; Arceneaux, S. ; Aguado, H. ; Nork, C. ; Boleman, B. ; Avery, P. ; Solomon, S. ; Orth, D. ; Macleod, C. ; Morrison, C. ; Lluen-Johnson, K. ; Bryant, D. ; Doherty, D. ; Folk, J. ; Boldt, C. ; Fountain, C. ; Griffin, M. ; Heffron, E. ; Vogel, C. ; Ward, B. ; Northway, R. ; Sabates, F. ; Schuchard, R. ; Sabates, N. ; Poulose, A. ; Crosser, V. ; Matta, C. ; Gallimore, G. ; Holz, E. R. ; Wood, W. ; Wolfe, J. ; Hawkins, L. ; Taul, Y. ; Oldroyd, M. ; Cornett, L. ; Van Arsdall, J. ; Slade, E. ; Harris, M. ; Chandra, S. ; Stevens, T. ; Meyers, F. ; Olsen, T. ; Walker, W. ; Knutson, G. ; Harrison, R. ; Neider, M. ; Wabers, H. ; Little, H. ; Blumenkranz, M. ; Showman, J. ; Hahn, T. ; Jimenez, L. ; Matio, P. ; Gitter, K. ; Cohen, G. ; Newell, K. ; Ross, R. ; Schomaker, K. ; Fine, S. L. ; Brucker, A. ; Ho, A. C. ; Maguire, A. ; Grunwald, J. ; Dupont, J. ; Kirschner, J. ; Sterling, E. ; Sheehan, M. ; Nyberg, B. ; Weeney, L. ; Reynolds, J. ; Elkins, D. ; Klein, Michael ; Wilson, David ; Nolte, S. / Laser treatment in eyes with large Drusen : Short-term effects seen in a pilot randomized clinical trial. In: Ophthalmology. 1998 ; Vol. 105, No. 1. pp. 11-23.
@article{5b76cf832c0740cba6807b5608ad83e4,
title = "Laser treatment in eyes with large Drusen: Short-term effects seen in a pilot randomized clinical trial",
abstract = "Objective: This study aimed to describe the short-term effects of low- intensity laser treatment in eyes with drusen at risk of having choroidal neovascularization (CNV) develop secondary to age-related macular degeneration. Design: The study design was a multicentered, randomized clinical trial of laser treatment versus observation. Participants: One hundred fifty-six patients without exudative age-related macular degeneration and with more than 10 large (>63 μm) drusen in each eye were enrolled in the Bilateral Drusen Study. One hundred twenty patients with exudative age- related macular degeneration in I eye and more than 10 large drusen in the other eye were enrolled in the Fellow Eye Study. Intervention: The treatment protocol for most (85{\%}) of the eyes consisted of 20 laser burns, 100 μm in diameter, in a pattern of 3 rows placed between the 12- and 6-o'clock positions beyond the temporal perimeter of the foveal avascular zone. The desired intensity of the bums was a gray-white lesion. Whenever the area of drusen had not been reduced by 50{\%} or more at 6 months, a second treatment was applied nasal to the fovea in a mirror image of the first treatment. During the last 6 months of enrollment, a second laser treatment protocol was adopted that specified 24 laser burns, 100 μm in diameter, in a circular pattern of 2 rows surrounding the macular drusen. Main Outcome Measures: Change in visual acuity is the primary outcome measure. Incidence of CNV, change in contrast threshold, and change in critical print size are secondary outcome measures. Results: In the Bilateral Drusen Study, CNV developed in 4 of 156 treated eyes and in 2 of 156 observed eyes (P = 0.62); in the Fellow Eye Study, the proportions are 10/59 treated eyes and 2/61 observed eyes (P = 0.02). Changes in visual acuity are similar in treated and observed eyes in the Bilateral Drusen Study through 18 months. However, by 18 months, observed eyes in the Fellow Eye Study have lost more visual acuity than treated eyes (P = 0.02). Changes in contrast threshold are similar in treated and observed eyes in each study. Conclusions: Laser treatment to high-risk fellow eyes may increase the short-term incidence of CNV. Long-term effects in fellow eyes and effects in patients with bilateral drusen require additional observation.",
author = "P. Sternberg and A. Capone and Aaberg, {T. M.} and M. Hyatt and J. Gilman and R. Swords and L. Singerman and Rice, {T. A.} and H. Zegarra and Novak, {M. A.} and S. Lichterman and D. Knight and K. Tilocco and M. Elk and G. Daley and G. Greanoff and J. Dubois and A. Lyon and L. Jampol and D. Weinberg and B. Chiapetta and Z. Strugala and L. Richine and Fish, {G. E.} and D. Callanan and T. Anderson and S. Arceneaux and H. Aguado and C. Nork and B. Boleman and P. Avery and S. Solomon and D. Orth and C. Macleod and C. Morrison and K. Lluen-Johnson and D. Bryant and D. Doherty and J. Folk and C. Boldt and C. Fountain and M. Griffin and E. Heffron and C. Vogel and B. Ward and R. Northway and F. Sabates and R. Schuchard and N. Sabates and A. Poulose and V. Crosser and C. Matta and G. Gallimore and Holz, {E. R.} and W. Wood and J. Wolfe and L. Hawkins and Y. Taul and M. Oldroyd and L. Cornett and {Van Arsdall}, J. and E. Slade and M. Harris and S. Chandra and T. Stevens and F. Meyers and T. Olsen and W. Walker and G. Knutson and R. Harrison and M. Neider and H. Wabers and H. Little and M. Blumenkranz and J. Showman and T. Hahn and L. Jimenez and P. Matio and K. Gitter and G. Cohen and K. Newell and R. Ross and K. Schomaker and Fine, {S. L.} and A. Brucker and Ho, {A. C.} and A. Maguire and J. Grunwald and J. Dupont and J. Kirschner and E. Sterling and M. Sheehan and B. Nyberg and L. Weeney and J. Reynolds and D. Elkins and Michael Klein and David Wilson and S. Nolte",
year = "1998",
doi = "10.1016/S0161-6420(98)90931-9",
language = "English (US)",
volume = "105",
pages = "11--23",
journal = "Ophthalmology",
issn = "0161-6420",
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TY - JOUR

T1 - Laser treatment in eyes with large Drusen

T2 - Short-term effects seen in a pilot randomized clinical trial

AU - Sternberg, P.

AU - Capone, A.

AU - Aaberg, T. M.

AU - Hyatt, M.

AU - Gilman, J.

AU - Swords, R.

AU - Singerman, L.

AU - Rice, T. A.

AU - Zegarra, H.

AU - Novak, M. A.

AU - Lichterman, S.

AU - Knight, D.

AU - Tilocco, K.

AU - Elk, M.

AU - Daley, G.

AU - Greanoff, G.

AU - Dubois, J.

AU - Lyon, A.

AU - Jampol, L.

AU - Weinberg, D.

AU - Chiapetta, B.

AU - Strugala, Z.

AU - Richine, L.

AU - Fish, G. E.

AU - Callanan, D.

AU - Anderson, T.

AU - Arceneaux, S.

AU - Aguado, H.

AU - Nork, C.

AU - Boleman, B.

AU - Avery, P.

AU - Solomon, S.

AU - Orth, D.

AU - Macleod, C.

AU - Morrison, C.

AU - Lluen-Johnson, K.

AU - Bryant, D.

AU - Doherty, D.

AU - Folk, J.

AU - Boldt, C.

AU - Fountain, C.

AU - Griffin, M.

AU - Heffron, E.

AU - Vogel, C.

AU - Ward, B.

AU - Northway, R.

AU - Sabates, F.

AU - Schuchard, R.

AU - Sabates, N.

AU - Poulose, A.

AU - Crosser, V.

AU - Matta, C.

AU - Gallimore, G.

AU - Holz, E. R.

AU - Wood, W.

AU - Wolfe, J.

AU - Hawkins, L.

AU - Taul, Y.

AU - Oldroyd, M.

AU - Cornett, L.

AU - Van Arsdall, J.

AU - Slade, E.

AU - Harris, M.

AU - Chandra, S.

AU - Stevens, T.

AU - Meyers, F.

AU - Olsen, T.

AU - Walker, W.

AU - Knutson, G.

AU - Harrison, R.

AU - Neider, M.

AU - Wabers, H.

AU - Little, H.

AU - Blumenkranz, M.

AU - Showman, J.

AU - Hahn, T.

AU - Jimenez, L.

AU - Matio, P.

AU - Gitter, K.

AU - Cohen, G.

AU - Newell, K.

AU - Ross, R.

AU - Schomaker, K.

AU - Fine, S. L.

AU - Brucker, A.

AU - Ho, A. C.

AU - Maguire, A.

AU - Grunwald, J.

AU - Dupont, J.

AU - Kirschner, J.

AU - Sterling, E.

AU - Sheehan, M.

AU - Nyberg, B.

AU - Weeney, L.

AU - Reynolds, J.

AU - Elkins, D.

AU - Klein, Michael

AU - Wilson, David

AU - Nolte, S.

PY - 1998

Y1 - 1998

N2 - Objective: This study aimed to describe the short-term effects of low- intensity laser treatment in eyes with drusen at risk of having choroidal neovascularization (CNV) develop secondary to age-related macular degeneration. Design: The study design was a multicentered, randomized clinical trial of laser treatment versus observation. Participants: One hundred fifty-six patients without exudative age-related macular degeneration and with more than 10 large (>63 μm) drusen in each eye were enrolled in the Bilateral Drusen Study. One hundred twenty patients with exudative age- related macular degeneration in I eye and more than 10 large drusen in the other eye were enrolled in the Fellow Eye Study. Intervention: The treatment protocol for most (85%) of the eyes consisted of 20 laser burns, 100 μm in diameter, in a pattern of 3 rows placed between the 12- and 6-o'clock positions beyond the temporal perimeter of the foveal avascular zone. The desired intensity of the bums was a gray-white lesion. Whenever the area of drusen had not been reduced by 50% or more at 6 months, a second treatment was applied nasal to the fovea in a mirror image of the first treatment. During the last 6 months of enrollment, a second laser treatment protocol was adopted that specified 24 laser burns, 100 μm in diameter, in a circular pattern of 2 rows surrounding the macular drusen. Main Outcome Measures: Change in visual acuity is the primary outcome measure. Incidence of CNV, change in contrast threshold, and change in critical print size are secondary outcome measures. Results: In the Bilateral Drusen Study, CNV developed in 4 of 156 treated eyes and in 2 of 156 observed eyes (P = 0.62); in the Fellow Eye Study, the proportions are 10/59 treated eyes and 2/61 observed eyes (P = 0.02). Changes in visual acuity are similar in treated and observed eyes in the Bilateral Drusen Study through 18 months. However, by 18 months, observed eyes in the Fellow Eye Study have lost more visual acuity than treated eyes (P = 0.02). Changes in contrast threshold are similar in treated and observed eyes in each study. Conclusions: Laser treatment to high-risk fellow eyes may increase the short-term incidence of CNV. Long-term effects in fellow eyes and effects in patients with bilateral drusen require additional observation.

AB - Objective: This study aimed to describe the short-term effects of low- intensity laser treatment in eyes with drusen at risk of having choroidal neovascularization (CNV) develop secondary to age-related macular degeneration. Design: The study design was a multicentered, randomized clinical trial of laser treatment versus observation. Participants: One hundred fifty-six patients without exudative age-related macular degeneration and with more than 10 large (>63 μm) drusen in each eye were enrolled in the Bilateral Drusen Study. One hundred twenty patients with exudative age- related macular degeneration in I eye and more than 10 large drusen in the other eye were enrolled in the Fellow Eye Study. Intervention: The treatment protocol for most (85%) of the eyes consisted of 20 laser burns, 100 μm in diameter, in a pattern of 3 rows placed between the 12- and 6-o'clock positions beyond the temporal perimeter of the foveal avascular zone. The desired intensity of the bums was a gray-white lesion. Whenever the area of drusen had not been reduced by 50% or more at 6 months, a second treatment was applied nasal to the fovea in a mirror image of the first treatment. During the last 6 months of enrollment, a second laser treatment protocol was adopted that specified 24 laser burns, 100 μm in diameter, in a circular pattern of 2 rows surrounding the macular drusen. Main Outcome Measures: Change in visual acuity is the primary outcome measure. Incidence of CNV, change in contrast threshold, and change in critical print size are secondary outcome measures. Results: In the Bilateral Drusen Study, CNV developed in 4 of 156 treated eyes and in 2 of 156 observed eyes (P = 0.62); in the Fellow Eye Study, the proportions are 10/59 treated eyes and 2/61 observed eyes (P = 0.02). Changes in visual acuity are similar in treated and observed eyes in the Bilateral Drusen Study through 18 months. However, by 18 months, observed eyes in the Fellow Eye Study have lost more visual acuity than treated eyes (P = 0.02). Changes in contrast threshold are similar in treated and observed eyes in each study. Conclusions: Laser treatment to high-risk fellow eyes may increase the short-term incidence of CNV. Long-term effects in fellow eyes and effects in patients with bilateral drusen require additional observation.

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U2 - 10.1016/S0161-6420(98)90931-9

DO - 10.1016/S0161-6420(98)90931-9

M3 - Article

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AN - SCOPUS:0009039018

VL - 105

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EP - 23

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 1

ER -