Functional effects of scatter macular photocoagulation for age-related subfoveal neovascularization

Purpose. To evaluate some functional effects of an indirect scatter macular photocoagulation technique for the treatment of well and ill-defined sufoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). Methods. Thirty-five eyes of 35 consecutive patients affected by subfoveal CNV in ARMD (20 well defined and 15 ill defined membranes) underwent argon green laser photocoagulation in an indirect macular scatter pattern (Retina 12:305,1992). Scanning laser ophthalmoscope (SLO) microperimetry was used to quantify retinal sensitivity of the macular area and to detect fixation point. Fluorescein and indocyanine green videoangiography were used to document the morpholog c behaviour of the membranes. Results. Indirect laser treatment resulted in stabilization of subfoveal CNV of both types (classic and ill defined), with less angiographic leakage in 75% of the cases. SLO retinal sensitivity decreased (mean 8 ± 3) dB in the macular area due to laser-induced scotomatous points. After photocoagulation fixation moved nasally, but it returned to the pre-treatment point after 3 months. The average pre-laser vision was equal to the post-laser vision after an average follow up to 8 months ( range 3 to 12 months). Conclusions. Indirect scatter laser treatment appears to be beneficial in the treatment of well and ill defined subfoveal CNV with long term manteinance of a relatively stable fixation and moderate decrease of macular sensitivity.