Abstract
Abstract: :
Purpose: To present the results of 40 patients diagnosed with IPCV who received treatment with the Argon laser. Methods: A retrospective study of patients diagnosed with and treated for IPCV between December 1997 and December 2003, who presented to a tertiary eye hospital in London. IPCV was diagnosed using indocyanine green angiography (IGA). All eyes received argon laser treatment(s). At initial presentation, visual acuity (VA), findings of fundus examination, fluorescein angiography and ICG were recorded. Lesions were classified according to: (1) location (peri–papillary [within 1DD from optic nerve], macular, extra–macular or mixed), (2) characteristics (isolated, clusters, ring or mixed) and (3) associated fundus findings (pigment epithelial detachment [PED] +/– macular involvement, sub–retinal fluid [SRF] +/– exudates or both). The main outcome measures of final VA (FVA) and lesion findings were assessed at 6 and 12 months intervals. The total number of laser treatments received by each eye was recorded. Exclusion criteria included: the presence of drusen in either eye, classical choroidal neovascular membrane and subfoveal IPCV lesions. Median follow–up duration was 11.1 months ( range 9 –14.7 ) Results: 40 eyes were analysed. 39 eyes received laser treatment on day 1; 1 eye had laser after 4.5 months. The median number of laser treatments performed was 1.0 (65% had only 1 laser, 35% more than 1 laser). 20 eyes (50%) had no change in FVA, 8 eyes (20%) had improved FVA and 12 eyes (30%) had worse FVA, (p=0.019 Chi–Sq test). For lesions with associated PED, 26% had no change, 11% improved from macular involvement to flattening of PED without macular involvement , 59% improved from macular involvement to flattening of PED with macular involvement and 4% got worse, (p=0.74). For lesions with SRF, 12.5% had no change, 87.5% showed signs of resolving SRF, 0% got worse, (p=0.018). For macular lesions, 56% had FVA better than 6/60, 44% had FVA of worse than 6/60. For peripapillary lesions, 44.4 % had FVA of 6/6–6/12 and 55.6% had FVA worse than 6/18. For extra–macular lesions, 50% had FVA of 6/6–6/12 and 50% 6/18–6/60. For mixed located lesions, 50% had FVA of 6/6–6/12 and 50% worse than 6/60. Conclusion: Argon laser photocoagulation provided stabilization of vision and may also improve the final visual acuities of eyes with IPCV. Treatment had a positive effect on the resolution of sub–retinal fluid associated with IPCV, but had an insignificant effect on associated PED lesions in IPCV.
Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled • retina • macula/fovea