Persistent and Recurrent Neovascularization After Laser Photocoagulation for Subfoveal Choroidal Neovascularization of Age-Related Macular Degeneration

Macular Photocoagulation Study Group

Research output: Contribution to journalArticle

138 Citations (Scopus)

Abstract

Objective: To determine the incidence and visual impact of and risk factors for persistent and recurrent neovascularization after laser photocoagulation of subfoveal choroidal neovascularization (CNV) in patients with age-related macular degeneration. Design, Patients, and Methods: The records of 189 eyes in the Subfoveal New CNV Study and 100 eyes in the Subfoveal Recurrent CNV Study assigned to laser photocoagulation were examined. Persistent CNV (detected within 6 weeks of treatment) and recurrent CNV (detected after 6 weeks) were defined angiographically by fluorescein leak-age from the periphery of the treatment scar. Incidence was estimated using survival analysis methods. Results: In both studies, persistent CNV was observed in approximately 13% of the eyes, and recurrent CNV was estimated to have developed by 3 years in an additional 35% of the eyes. In the New CNV Study, by 3 years, 36% of the eyes with persistent CNV had lost 6 or more lines of visual acuity as had 19% of the eyes with recurrent CNV and 27% of the eyes without persistence or recurrence. The presence of neovascular maculopathy in the fellow eye was associated with an increased risk for persistence or recurrence in the study eye. In the New CNV Study, partial coverage of the lesion with heavy laser treatment and/or runoff was associated with increased risk for persistence; less extensive natural scarring of the lesion at study entry was associated with increased risk for recurrence. Conclusions: Close to half of the eyes treated for sub foveal CNV have persistent or recurrent CNV within 3 years. There is a strong association between neovascular maculopathy in the fellow eye and the inability of laser photocoagulation to permanently obliterate signs of CNV from the study eye. Within these two studies, there was little additional damage to visual function resulting from persistent or recurrent neovascularization. There appears to be no reason to deviate from the protocol goal of covering the entire neovascular complex when treating eyes with subfoveal CNV.

Original languageEnglish (US)
Pages (from-to)489-499
Number of pages11
JournalArchives of Ophthalmology
Volume112
Issue number4
DOIs
StatePublished - 1994
Externally publishedYes

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Choroidal Neovascularization
Light Coagulation
Macular Degeneration
Lasers
Recurrence
Cicatrix
Incidence
Survival Analysis
Fluorescein

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Persistent and Recurrent Neovascularization After Laser Photocoagulation for Subfoveal Choroidal Neovascularization of Age-Related Macular Degeneration. / Macular Photocoagulation Study Group.

In: Archives of Ophthalmology, Vol. 112, No. 4, 1994, p. 489-499.

Research output: Contribution to journalArticle

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title = "Persistent and Recurrent Neovascularization After Laser Photocoagulation for Subfoveal Choroidal Neovascularization of Age-Related Macular Degeneration",
abstract = "Objective: To determine the incidence and visual impact of and risk factors for persistent and recurrent neovascularization after laser photocoagulation of subfoveal choroidal neovascularization (CNV) in patients with age-related macular degeneration. Design, Patients, and Methods: The records of 189 eyes in the Subfoveal New CNV Study and 100 eyes in the Subfoveal Recurrent CNV Study assigned to laser photocoagulation were examined. Persistent CNV (detected within 6 weeks of treatment) and recurrent CNV (detected after 6 weeks) were defined angiographically by fluorescein leak-age from the periphery of the treatment scar. Incidence was estimated using survival analysis methods. Results: In both studies, persistent CNV was observed in approximately 13{\%} of the eyes, and recurrent CNV was estimated to have developed by 3 years in an additional 35{\%} of the eyes. In the New CNV Study, by 3 years, 36{\%} of the eyes with persistent CNV had lost 6 or more lines of visual acuity as had 19{\%} of the eyes with recurrent CNV and 27{\%} of the eyes without persistence or recurrence. The presence of neovascular maculopathy in the fellow eye was associated with an increased risk for persistence or recurrence in the study eye. In the New CNV Study, partial coverage of the lesion with heavy laser treatment and/or runoff was associated with increased risk for persistence; less extensive natural scarring of the lesion at study entry was associated with increased risk for recurrence. Conclusions: Close to half of the eyes treated for sub foveal CNV have persistent or recurrent CNV within 3 years. There is a strong association between neovascular maculopathy in the fellow eye and the inability of laser photocoagulation to permanently obliterate signs of CNV from the study eye. Within these two studies, there was little additional damage to visual function resulting from persistent or recurrent neovascularization. There appears to be no reason to deviate from the protocol goal of covering the entire neovascular complex when treating eyes with subfoveal CNV.",
author = "{Macular Photocoagulation Study Group} and Maguire, {Maureen G.} and Michael Klein and Olk, {R. Joseph} and Phillips, {Deborah A.} and Judith Alexander and Javornik, {Noreen B.} and Cheryl Hiner and Marsh, {Marta J.} and Bressler, {Neil M.} and Singerman, {Lawrence J.} and Jim Matheny and Jayne Brown",
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T1 - Persistent and Recurrent Neovascularization After Laser Photocoagulation for Subfoveal Choroidal Neovascularization of Age-Related Macular Degeneration

AU - Macular Photocoagulation Study Group

AU - Maguire, Maureen G.

AU - Klein, Michael

AU - Olk, R. Joseph

AU - Phillips, Deborah A.

AU - Alexander, Judith

AU - Javornik, Noreen B.

AU - Hiner, Cheryl

AU - Marsh, Marta J.

AU - Bressler, Neil M.

AU - Singerman, Lawrence J.

AU - Matheny, Jim

AU - Brown, Jayne

PY - 1994

Y1 - 1994

N2 - Objective: To determine the incidence and visual impact of and risk factors for persistent and recurrent neovascularization after laser photocoagulation of subfoveal choroidal neovascularization (CNV) in patients with age-related macular degeneration. Design, Patients, and Methods: The records of 189 eyes in the Subfoveal New CNV Study and 100 eyes in the Subfoveal Recurrent CNV Study assigned to laser photocoagulation were examined. Persistent CNV (detected within 6 weeks of treatment) and recurrent CNV (detected after 6 weeks) were defined angiographically by fluorescein leak-age from the periphery of the treatment scar. Incidence was estimated using survival analysis methods. Results: In both studies, persistent CNV was observed in approximately 13% of the eyes, and recurrent CNV was estimated to have developed by 3 years in an additional 35% of the eyes. In the New CNV Study, by 3 years, 36% of the eyes with persistent CNV had lost 6 or more lines of visual acuity as had 19% of the eyes with recurrent CNV and 27% of the eyes without persistence or recurrence. The presence of neovascular maculopathy in the fellow eye was associated with an increased risk for persistence or recurrence in the study eye. In the New CNV Study, partial coverage of the lesion with heavy laser treatment and/or runoff was associated with increased risk for persistence; less extensive natural scarring of the lesion at study entry was associated with increased risk for recurrence. Conclusions: Close to half of the eyes treated for sub foveal CNV have persistent or recurrent CNV within 3 years. There is a strong association between neovascular maculopathy in the fellow eye and the inability of laser photocoagulation to permanently obliterate signs of CNV from the study eye. Within these two studies, there was little additional damage to visual function resulting from persistent or recurrent neovascularization. There appears to be no reason to deviate from the protocol goal of covering the entire neovascular complex when treating eyes with subfoveal CNV.

AB - Objective: To determine the incidence and visual impact of and risk factors for persistent and recurrent neovascularization after laser photocoagulation of subfoveal choroidal neovascularization (CNV) in patients with age-related macular degeneration. Design, Patients, and Methods: The records of 189 eyes in the Subfoveal New CNV Study and 100 eyes in the Subfoveal Recurrent CNV Study assigned to laser photocoagulation were examined. Persistent CNV (detected within 6 weeks of treatment) and recurrent CNV (detected after 6 weeks) were defined angiographically by fluorescein leak-age from the periphery of the treatment scar. Incidence was estimated using survival analysis methods. Results: In both studies, persistent CNV was observed in approximately 13% of the eyes, and recurrent CNV was estimated to have developed by 3 years in an additional 35% of the eyes. In the New CNV Study, by 3 years, 36% of the eyes with persistent CNV had lost 6 or more lines of visual acuity as had 19% of the eyes with recurrent CNV and 27% of the eyes without persistence or recurrence. The presence of neovascular maculopathy in the fellow eye was associated with an increased risk for persistence or recurrence in the study eye. In the New CNV Study, partial coverage of the lesion with heavy laser treatment and/or runoff was associated with increased risk for persistence; less extensive natural scarring of the lesion at study entry was associated with increased risk for recurrence. Conclusions: Close to half of the eyes treated for sub foveal CNV have persistent or recurrent CNV within 3 years. There is a strong association between neovascular maculopathy in the fellow eye and the inability of laser photocoagulation to permanently obliterate signs of CNV from the study eye. Within these two studies, there was little additional damage to visual function resulting from persistent or recurrent neovascularization. There appears to be no reason to deviate from the protocol goal of covering the entire neovascular complex when treating eyes with subfoveal CNV.

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