Abstract
Abstract: :
Purpose:To determine if drusen reduction with diffuse diode laser using large spot size, low energy and long duration (4200 microns x 400 mw x 60s) could be achieved safely in patients with age related macular degeneration (AMD) at high risk of visual loss. This strategy avoids focal Bruch’s membrane damage. Methods:Patients were enrolled for a prospective double masked randomised controlled trial at King’s College Hospital, London. To be eligible they had subfoveal choroidal neovascularisation (CNV) from AMD in one eye and significant drusen (>5 large drusen or >20 small drusen) in the fellow eye. Patients with ocular morbidity other than AMD were excluded. The control group received sham treatment with no energy is applied. Colour fundus photographs were evaluated to determine reduction of drusen. Visual acuity, contrast sensitivity and color contrast sensitivity were recorded every 3 months. Results:Twenty one patients were recruited so far into the study. Preliminary analysis showed some reduction of soft drusen in the treatment group by six months. No changes in hard drusen were noted. There were no adverse events or symptoms reported in the treatment group. Visual acuities were stable in all patients except 2 patients in the sham treatment group, of whom one developed CNV and one developed central retinal artery occlusion Conclusion:Treatment of drusen with diffuse laser in patients at high risk of visual loss appears to be safe at 6 months post treatment. Longer term follow up and with more patients will determine whether the reduction of soft drusen and/or prevention of CNV formation will be significant for this treatment strategy.
Keywords: age–related macular degeneration • laser • drusen