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JR Ferencz, G Gilady, O Harel, M Belkin, EI Assia; Topical Brimonidine Possibly Reduces Collateral Damage caused by Laser Photocoagulation for Choroidal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1219.
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Purpose: To evaluate the efficacy of brimonidine (Alphagan®), an intra-ocular pressure lowering compound with neuroprotective properties, given topically to eyes that underwent focal conventional laser treatment for extrafoveal choroidal neovascularization (CNV), and to report the visual outcome in a pilot prospective double masked study. Methods: Twenty patients with extra foveal or juxtafoveal CNV were randomized to either brimonidine 0.2% or placebo treatment groups. Medications were given topically preoperatively and continued for 2 months b.i.d. postoperatively. Visual acuity (VA) measured by Snellen lines before and 2 months after laser treatment was the outcome measure. The paired T-test was used to calculate statistical significance. Results: Four patients, 2 from each group, had subfoveal recurrences that caused severe visual loss. Statistical analysis of the 20 patients including the 4 with subfoveal recurrences showed a trend, yet below statistical significance, between the initial and final visual acuities in the brimonidine group only. Excluding these 4 patients with recurrence from the statistical analysis revealed the following (Table 1): Table 1 View OriginalDownload SlideView OriginalDownload Slide Conclusion: These results suggest that treatment with brimonidine may improve the visual outcome after laser treatment of CNV, possibly by reducing the collateral damage to the retinal ganglion cells that was inflicted by laser photocoagulation. Study of larger numbers of patients is required to confirm the results of this pilot study.
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