Original ArticlesProphylactic laser treatment to fellow eyes of unilateral retinal pigment epithelial tears
Section snippets
Patients and methods
We prospectively studied 12 patients with age-related macular degeneration who presented with a retinal pigment epithelial tear in one eye and drusen in the fellow eye. The mean patient age was 76 years (range, 62 to 86 years), and there were 10 women and two men. The initial mean best-corrected visual acuity of the fellow eye was 20/30 (range, 20/20 to 20/40). On fluorescein angiography of the fellow eye, four patients showed hypofluorescent drusen (Patients 4, 5, and 8), two patients had
Results
After we performed prophylactic laser treatment on 12 fellow eyes of eyes with retinal pigment epithelial tears caused by age-related macular degeneration, we retreated Patient 4 after 14 months and Patient 11 after 4 months because the appearance of their large confluent drusen had not changed. Patient 8 had received relatively intense laser treatment initially. After 4 months, her drusen had completely disappeared, but she had developed choroidal neovascularization at one laser scar with
Discussion
Because of the poor prognosis for the fellow eye of patients with unilateral tears of the retinal pigment epithelium, we attempted to lower this risk by placing low-intensity laser spots in the macular region of the fellow eye. The rational for treatment is based on the concept that detachment of the retinal pigment epithelium is caused by diffuse thickening of the Bruch membrane. Particularly in patients with pigment epithelial tears, we often observe delayed choroidal filling on fluorescein
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