Treatment to fellow eyes of unilateral retinal pigment epithelial tears with prophylactic laser

Purpose. A retinal pigment epithelial tear due to age-related macular disease (AMD) in one eye implies a high risk of visual loss in the fellow eye (Schoeppner G et al.: Am J Ophthalmol. 1989;108:683-685). We propose that this risk may be reduced through prophylactic laser treatment to the fellow eye. Methods. Twelve patients with a pigment epithelial tear in one eye due to AMD received prophylactic laser treatment to their fellow eye, and were reviewed for at least 18 months, ten patients were followed for two years. Twelve Argon green laser burns were placed 600μm to 1000μm away from the foveola. A spot size of 200μm and a duration of 0.2 sec at the lowest possible intensity for achieving a very faint burn was used. Results. The loss of visual acuity to 6/24 or worse in the treated fellow eye was reduced from 37% to 8% in the first year and from 59% to 39% in the second year, when compared to our natural history data. Conclusions. These data suggest that the risk of visual loss in the fellow eye of patients with a retinal pigment epithelial tear is reduced by low intensity photocoagulations of the posterior pole.