Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial

Maureen G. Maguire; Paul Sternberg; Thomas M. Aaberg; Daniel Martin; David Saperstein; Maureen Hyatt; James Gilman; Ray Swords; Gabriela Nemes; Lawrence J. Singerman; Thomas A. Rice; Hernando Zegarra; Michael A. Novak; Scott Pendergast; Z. Nicholas Zakov; John Niffenegger; Michelle Bartel; Susan Lichterman; Donna Knight; Kim Tilocco-DuBois; Mary Ilk; Geraldine Daley; Gregg Greanoff; John DuBois; Diane Weiss; Alice Lyon; Lee Jampol; David Weinberg; Beth Chiapetta; Zuzanna Strugala; Len Richine; Gary Edd Fish; David Callanan; Bradley Jost; Rajiv Anand; William B. Snyder; Dwain Fuller; Theresa Anderson; Sally Arceneaux; Hank Aguado; Cynthia Nork; Bob Boleman; Penny Avery; Sue Solomon; John King; David Orth; Kirk Packo; Jack Cohen; Serge DeBustros; Celeste Figliulo; Chris Morrison; Katherine Lluen-Johnson; Douglas Bryant; Don Doherty; James Folk; H. Culver Boldt; Karen Gehrs; Stephen Russell; Connie Fountain; Marcia Griffin; Ed Heffron; Carolyn Vogel; Bill Ward; Ray Northway; Felix Sabates; Ron Schuchard; Nelson Sabates; Abraham Poulose; Vicki Crosser; Camille Matta; Mickie Keeling; Hong Lei; Gary Gallimore; Eric R. Holz; William Wood; Rick Isernhagen; Jenny Wolfe; Lisa Hawkins; Yvonne Taul; Mary Oldroyd; Leslie Cornett; Jeanne Van Arsdall; Edward Slade; Melanie Harris; Suresh Chandra; Thomas Stevens; Frank Meyers; Timothy Olsen; Barbara Blodi; Justin Gottlieb; Wendy Walker; Jennie Perry; Gene Knutson; Robert Harrison; Michael Neider; Hugh Wabers; Hunter Little; Mark Blumenkranz; Robert Jack

doi:10.1016/S0161-6420(03)00098-8

Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial

Maureen G. Maguire, Paul Sternberg, Thomas M. Aaberg, Daniel Martin, David Saperstein, Maureen Hyatt, James Gilman, Ray Swords, Gabriela Nemes, Lawrence J. Singerman, Thomas A. Rice, Hernando Zegarra, Michael A. Novak, Scott Pendergast, Z. Nicholas Zakov, John Niffenegger, Michelle Bartel, Susan Lichterman, Donna Knight, Kim Tilocco-DuBoisMary Ilk, Geraldine Daley, Gregg Greanoff, John DuBois, Diane Weiss, Alice Lyon, Lee Jampol, David Weinberg, Beth Chiapetta, Zuzanna Strugala, Len Richine, Gary Edd Fish, David Callanan, Bradley Jost, Rajiv Anand, William B. Snyder, Dwain Fuller, Theresa Anderson, Sally Arceneaux, Hank Aguado, Cynthia Nork, Bob Boleman, Penny Avery, Sue Solomon, John King, David Orth, Kirk Packo, Jack Cohen, Serge DeBustros, Celeste Figliulo, Chris Morrison, Katherine Lluen-Johnson, Douglas Bryant, Don Doherty, James Folk, H. Culver Boldt, Karen Gehrs, Stephen Russell, Connie Fountain, Marcia Griffin, Ed Heffron, Carolyn Vogel, Bill Ward, Ray Northway, Felix Sabates, Ron Schuchard, Nelson Sabates, Abraham Poulose, Vicki Crosser, Camille Matta, Mickie Keeling, Hong Lei, Gary Gallimore, Eric R. Holz, William Wood, Rick Isernhagen, Jenny Wolfe, Lisa Hawkins, Yvonne Taul, Mary Oldroyd, Leslie Cornett, Jeanne Van Arsdall, Edward Slade, Melanie Harris, Suresh Chandra, Thomas Stevens, Frank Meyers, Timothy Olsen, Barbara Blodi, Justin Gottlieb, Wendy Walker, Jennie Perry, Gene Knutson, Robert Harrison, Michael Neider, Hugh Wabers, Hunter Little, Mark Blumenkranz, Robert Jack

Ophthalmology

Research output: Contribution to journal › Article › peer-review

41 Scopus citations

Abstract

Purpose: To update the findings from the Choroidal Neovascularization Prevention Trial (CNVPT) with respect to resolution of drusen, incidence of choroidal neovascularization, and visual function. Design: A multicenter, randomized, controlled, pilot clinical trial. Participants: The 120 patients enrolled in the CNVPT. Patients had signs of choroidal neovascularization or retinal pigment epithelial detachment in 1 eye and had ≥10 large (>63-μm) drusen in the contralateral, or fellow, eye. Intervention: The fellow eye of 59 patients was assigned randomly to argon green laser treatment consisting of multiple 100-μm spots at least 750 μm from the center of the fovea. The fellow eye of the remaining 61 patients was assigned randomly to observation. Main Outcome Measures: Change in visual acuity was the primary outcome measure. Incidence of choroidal neovascularization, resolution of drusen, change in contrast threshold, change in critical print size for reading, and incidence of geographic atrophy were secondary outcome measures. Results: Throughout 4 years of follow-up, there were no statistically significant differences in change in visual acuity, contrast threshold, critical print size, or incidence of geographic atrophy. With additional follow-up, the large increase in the incidence of choroidal neovascularization observed within 18 months of treatment was maintained; however, by 30 months, the incidence in the two treatment groups was the same. Most drusen resolution in treated eyes occurred within 24 months of the initial treatment. Treated eyes that received higher-intensity laser burns had an increased risk of choroidal neovascularization. Among eyes developing choroidal neovascularization in each treatment group, most lesions (two thirds or more) were composed of occult neovascularization only. Conclusions: Laser treatment as applied in the CNVPT caused an excess risk of choroidal neovascularization in the first year or so after treatment. The increased early incidence of choroidal neovascularization was not associated with either a harmful or beneficial effect in this pilot study.

Original language	English (US)
Pages (from-to)	971-978
Number of pages	8
Journal	Ophthalmology
Volume	110
Issue number	5
DOIs	https://doi.org/10.1016/S0161-6420(03)00098-8
State	Published - May 1 2003

ASJC Scopus subject areas

Ophthalmology

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10.1016/S0161-6420(03)00098-8

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Maguire, M. G., Sternberg, P., Aaberg, T. M., Martin, D., Saperstein, D., Hyatt, M., Gilman, J., Swords, R., Nemes, G., Singerman, L. J., Rice, T. A., Zegarra, H., Novak, M. A., Pendergast, S., Zakov, Z. N., Niffenegger, J., Bartel, M., Lichterman, S., Knight, D., ... Jack, R. (2003). Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial. Ophthalmology, 110(5), 971-978. https://doi.org/10.1016/S0161-6420(03)00098-8

Maguire, MG, Sternberg, P, Aaberg, TM, Martin, D, Saperstein, D, Hyatt, M, Gilman, J, Swords, R, Nemes, G, Singerman, LJ, Rice, TA, Zegarra, H, Novak, MA, Pendergast, S, Zakov, ZN, Niffenegger, J, Bartel, M, Lichterman, S, Knight, D, Tilocco-DuBois, K, Ilk, M, Daley, G, Greanoff, G, DuBois, J, Weiss, D, Lyon, A, Jampol, L, Weinberg, D, Chiapetta, B, Strugala, Z, Richine, L, Fish, GE, Callanan, D, Jost, B, Anand, R, Snyder, WB, Fuller, D, Anderson, T, Arceneaux, S, Aguado, H, Nork, C, Boleman, B, Avery, P, Solomon, S, King, J, Orth, D, Packo, K, Cohen, J, DeBustros, S, Figliulo, C, Morrison, C, Lluen-Johnson, K, Bryant, D, Doherty, D, Folk, J, Boldt, HC, Gehrs, K, Russell, S, Fountain, C, Griffin, M, Heffron, E, Vogel, C, Ward, B, Northway, R, Sabates, F, Schuchard, R, Sabates, N, Poulose, A, Crosser, V, Matta, C, Keeling, M, Lei, H, Gallimore, G, Holz, ER, Wood, W, Isernhagen, R, 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, Blodi, B, Gottlieb, J, Walker, W, Perry, J, Knutson, G, Harrison, R, Neider, M, Wabers, H, Little, H, Blumenkranz, M & Jack, R 2003, 'Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial', Ophthalmology, vol. 110, no. 5, pp. 971-978. https://doi.org/10.1016/S0161-6420(03)00098-8

@article{a724a021014e4787a941c6214f9716bf,

title = "Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial",

abstract = "Purpose: To update the findings from the Choroidal Neovascularization Prevention Trial (CNVPT) with respect to resolution of drusen, incidence of choroidal neovascularization, and visual function. Design: A multicenter, randomized, controlled, pilot clinical trial. Participants: The 120 patients enrolled in the CNVPT. Patients had signs of choroidal neovascularization or retinal pigment epithelial detachment in 1 eye and had ≥10 large (>63-μm) drusen in the contralateral, or fellow, eye. Intervention: The fellow eye of 59 patients was assigned randomly to argon green laser treatment consisting of multiple 100-μm spots at least 750 μm from the center of the fovea. The fellow eye of the remaining 61 patients was assigned randomly to observation. Main Outcome Measures: Change in visual acuity was the primary outcome measure. Incidence of choroidal neovascularization, resolution of drusen, change in contrast threshold, change in critical print size for reading, and incidence of geographic atrophy were secondary outcome measures. Results: Throughout 4 years of follow-up, there were no statistically significant differences in change in visual acuity, contrast threshold, critical print size, or incidence of geographic atrophy. With additional follow-up, the large increase in the incidence of choroidal neovascularization observed within 18 months of treatment was maintained; however, by 30 months, the incidence in the two treatment groups was the same. Most drusen resolution in treated eyes occurred within 24 months of the initial treatment. Treated eyes that received higher-intensity laser burns had an increased risk of choroidal neovascularization. Among eyes developing choroidal neovascularization in each treatment group, most lesions (two thirds or more) were composed of occult neovascularization only. Conclusions: Laser treatment as applied in the CNVPT caused an excess risk of choroidal neovascularization in the first year or so after treatment. The increased early incidence of choroidal neovascularization was not associated with either a harmful or beneficial effect in this pilot study.",

author = "Maguire, {Maureen G.} and Paul Sternberg and Aaberg, {Thomas M.} and Daniel Martin and David Saperstein and Maureen Hyatt and James Gilman and Ray Swords and Gabriela Nemes and Singerman, {Lawrence J.} and Rice, {Thomas A.} and Hernando Zegarra and Novak, {Michael A.} and Scott Pendergast and Zakov, {Z. Nicholas} and John Niffenegger and Michelle Bartel and Susan Lichterman and Donna Knight and Kim Tilocco-DuBois and Mary Ilk and Geraldine Daley and Gregg Greanoff and John DuBois and Diane Weiss and Alice Lyon and Lee Jampol and David Weinberg and Beth Chiapetta and Zuzanna Strugala and Len Richine and Fish, {Gary Edd} and David Callanan and Bradley Jost and Rajiv Anand and Snyder, {William B.} and Dwain Fuller and Theresa Anderson and Sally Arceneaux and Hank Aguado and Cynthia Nork and Bob Boleman and Penny Avery and Sue Solomon and John King and David Orth and Kirk Packo and Jack Cohen and Serge DeBustros and Celeste Figliulo and Chris Morrison and Katherine Lluen-Johnson and Douglas Bryant and Don Doherty and James Folk and Boldt, {H. Culver} and Karen Gehrs and Stephen Russell and Connie Fountain and Marcia Griffin and Ed Heffron and Carolyn Vogel and Bill Ward and Ray Northway and Felix Sabates and Ron Schuchard and Nelson Sabates and Abraham Poulose and Vicki Crosser and Camille Matta and Mickie Keeling and Hong Lei and Gary Gallimore and Holz, {Eric R.} and William Wood and Rick Isernhagen and Jenny Wolfe and Lisa Hawkins and Yvonne Taul and Mary Oldroyd and Leslie Cornett and {Van Arsdall}, Jeanne and Edward Slade and Melanie Harris and Suresh Chandra and Thomas Stevens and Frank Meyers and Timothy Olsen and Barbara Blodi and Justin Gottlieb and Wendy Walker and Jennie Perry and Gene Knutson and Robert Harrison and Michael Neider and Hugh Wabers and Hunter Little and Mark Blumenkranz and Robert Jack",

note = "Funding Information: Supported by an unrestricted gift from Research to Prevent Blindness, New York, NY, to the University of Pennsylvania; gifts to the Macular Degeneration Research Fund, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA; grants from the Macula Foundation, New York, NY; Research Foundation of the University of Pennsylvania, Philadelphia, PA; and Mackall Trust, New York, NY; and grant R21 EY11275 from the National Eye Institute, National Institutes of Health, Bethesda, MD. ",

year = "2003",

month = may,

day = "1",

doi = "10.1016/S0161-6420(03)00098-8",

language = "English (US)",

volume = "110",

pages = "971--978",

journal = "Ophthalmology",

issn = "0161-6420",

publisher = "Elsevier Inc.",

number = "5",

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TY - JOUR

T1 - Laser treatment in fellow eyes with large drusen

T2 - Updated findings from a pilot randomized clinical trial

AU - Maguire, Maureen G.

AU - Sternberg, Paul

AU - Aaberg, Thomas M.

AU - Martin, Daniel

AU - Saperstein, David

AU - Hyatt, Maureen

AU - Gilman, James

AU - Swords, Ray

AU - Nemes, Gabriela

AU - Singerman, Lawrence J.

AU - Rice, Thomas A.

AU - Zegarra, Hernando

AU - Novak, Michael A.

AU - Pendergast, Scott

AU - Zakov, Z. Nicholas

AU - Niffenegger, John

AU - Bartel, Michelle

AU - Lichterman, Susan

AU - Knight, Donna

AU - Tilocco-DuBois, Kim

AU - Ilk, Mary

AU - Daley, Geraldine

AU - Greanoff, Gregg

AU - DuBois, John

AU - Weiss, Diane

AU - Lyon, Alice

AU - Jampol, Lee

AU - Weinberg, David

AU - Chiapetta, Beth

AU - Strugala, Zuzanna

AU - Richine, Len

AU - Fish, Gary Edd

AU - Callanan, David

AU - Jost, Bradley

AU - Anand, Rajiv

AU - Snyder, William B.

AU - Fuller, Dwain

AU - Anderson, Theresa

AU - Arceneaux, Sally

AU - Aguado, Hank

AU - Nork, Cynthia

AU - Boleman, Bob

AU - Avery, Penny

AU - Solomon, Sue

AU - King, John

AU - Orth, David

AU - Packo, Kirk

AU - Cohen, Jack

AU - DeBustros, Serge

AU - Figliulo, Celeste

AU - Morrison, Chris

AU - Lluen-Johnson, Katherine

AU - Bryant, Douglas

AU - Doherty, Don

AU - Folk, James

AU - Boldt, H. Culver

AU - Gehrs, Karen

AU - Russell, Stephen

AU - Fountain, Connie

AU - Griffin, Marcia

AU - Heffron, Ed

AU - Vogel, Carolyn

AU - Ward, Bill

AU - Northway, Ray

AU - Sabates, Felix

AU - Schuchard, Ron

AU - Sabates, Nelson

AU - Poulose, Abraham

AU - Crosser, Vicki

AU - Matta, Camille

AU - Keeling, Mickie

AU - Lei, Hong

AU - Gallimore, Gary

AU - Holz, Eric R.

AU - Wood, William

AU - Isernhagen, Rick

AU - Wolfe, Jenny

AU - Hawkins, Lisa

AU - Taul, Yvonne

AU - Oldroyd, Mary

AU - Cornett, Leslie

AU - Van Arsdall, Jeanne

AU - Slade, Edward

AU - Harris, Melanie

AU - Chandra, Suresh

AU - Stevens, Thomas

AU - Meyers, Frank

AU - Olsen, Timothy

AU - Blodi, Barbara

AU - Gottlieb, Justin

AU - Walker, Wendy

AU - Perry, Jennie

AU - Knutson, Gene

AU - Harrison, Robert

AU - Neider, Michael

AU - Wabers, Hugh

AU - Little, Hunter

AU - Blumenkranz, Mark

AU - Jack, Robert

N1 - Funding Information: Supported by an unrestricted gift from Research to Prevent Blindness, New York, NY, to the University of Pennsylvania; gifts to the Macular Degeneration Research Fund, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA; grants from the Macula Foundation, New York, NY; Research Foundation of the University of Pennsylvania, Philadelphia, PA; and Mackall Trust, New York, NY; and grant R21 EY11275 from the National Eye Institute, National Institutes of Health, Bethesda, MD.

PY - 2003/5/1

Y1 - 2003/5/1

N2 - Purpose: To update the findings from the Choroidal Neovascularization Prevention Trial (CNVPT) with respect to resolution of drusen, incidence of choroidal neovascularization, and visual function. Design: A multicenter, randomized, controlled, pilot clinical trial. Participants: The 120 patients enrolled in the CNVPT. Patients had signs of choroidal neovascularization or retinal pigment epithelial detachment in 1 eye and had ≥10 large (>63-μm) drusen in the contralateral, or fellow, eye. Intervention: The fellow eye of 59 patients was assigned randomly to argon green laser treatment consisting of multiple 100-μm spots at least 750 μm from the center of the fovea. The fellow eye of the remaining 61 patients was assigned randomly to observation. Main Outcome Measures: Change in visual acuity was the primary outcome measure. Incidence of choroidal neovascularization, resolution of drusen, change in contrast threshold, change in critical print size for reading, and incidence of geographic atrophy were secondary outcome measures. Results: Throughout 4 years of follow-up, there were no statistically significant differences in change in visual acuity, contrast threshold, critical print size, or incidence of geographic atrophy. With additional follow-up, the large increase in the incidence of choroidal neovascularization observed within 18 months of treatment was maintained; however, by 30 months, the incidence in the two treatment groups was the same. Most drusen resolution in treated eyes occurred within 24 months of the initial treatment. Treated eyes that received higher-intensity laser burns had an increased risk of choroidal neovascularization. Among eyes developing choroidal neovascularization in each treatment group, most lesions (two thirds or more) were composed of occult neovascularization only. Conclusions: Laser treatment as applied in the CNVPT caused an excess risk of choroidal neovascularization in the first year or so after treatment. The increased early incidence of choroidal neovascularization was not associated with either a harmful or beneficial effect in this pilot study.

AB - Purpose: To update the findings from the Choroidal Neovascularization Prevention Trial (CNVPT) with respect to resolution of drusen, incidence of choroidal neovascularization, and visual function. Design: A multicenter, randomized, controlled, pilot clinical trial. Participants: The 120 patients enrolled in the CNVPT. Patients had signs of choroidal neovascularization or retinal pigment epithelial detachment in 1 eye and had ≥10 large (>63-μm) drusen in the contralateral, or fellow, eye. Intervention: The fellow eye of 59 patients was assigned randomly to argon green laser treatment consisting of multiple 100-μm spots at least 750 μm from the center of the fovea. The fellow eye of the remaining 61 patients was assigned randomly to observation. Main Outcome Measures: Change in visual acuity was the primary outcome measure. Incidence of choroidal neovascularization, resolution of drusen, change in contrast threshold, change in critical print size for reading, and incidence of geographic atrophy were secondary outcome measures. Results: Throughout 4 years of follow-up, there were no statistically significant differences in change in visual acuity, contrast threshold, critical print size, or incidence of geographic atrophy. With additional follow-up, the large increase in the incidence of choroidal neovascularization observed within 18 months of treatment was maintained; however, by 30 months, the incidence in the two treatment groups was the same. Most drusen resolution in treated eyes occurred within 24 months of the initial treatment. Treated eyes that received higher-intensity laser burns had an increased risk of choroidal neovascularization. Among eyes developing choroidal neovascularization in each treatment group, most lesions (two thirds or more) were composed of occult neovascularization only. Conclusions: Laser treatment as applied in the CNVPT caused an excess risk of choroidal neovascularization in the first year or so after treatment. The increased early incidence of choroidal neovascularization was not associated with either a harmful or beneficial effect in this pilot study.

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UR - http://www.scopus.com/inward/citedby.url?scp=0037542839&partnerID=8YFLogxK

U2 - 10.1016/S0161-6420(03)00098-8

DO - 10.1016/S0161-6420(03)00098-8

M3 - Article

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AN - SCOPUS:0037542839

SN - 0161-6420

VL - 110

SP - 971

EP - 978

JO - Ophthalmology

JF - Ophthalmology

IS - 5

ER -

Laser treatment in fellow eyes with large drusen: Updated findings from a pilot randomized clinical trial

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