Owens Sarah L, Bunce Catey, Brannon Alan J, Xing Wen, Chisholm Iain H, Gross Mirjam, Guymer Robyn H, Holz Frank G, Bird Alan C
Moorfields Eye Hospital, London, United Kingdom, and the Universitätsklinikum Benjamin Franklin, Berlin, Germany.
Am J Ophthalmol. 2006 Feb;141(2):276-81. doi: 10.1016/j.ajo.2005.08.019.
The Drusen Laser Study evaluated macular laser to prevent choroidal neovascularization (CNV) and vision loss in high-risk age-related maculopathy (ARM).
Prospective, interventional, randomized, controlled clinical trial in five hospital centers.
Patients in the unilateral group had neovascular ARM and drusen in the study eye. Study eyes were randomized to laser-treated or no-laser groups. For patients in the bilateral drusen group, eyes were randomized to right eye, laser or no laser; and left eye, alternative. Laser treatment comprised 12 argon spots. Outcome was best-corrected visual acuity and CNV signs, which were monitored for 3 years.
In the unilateral group, vision loss occurred in 21 (28.8%) of 73 patients in laser vs 13 (19.7%) of 66 no-laser patients (P=.214). Incidence of CNV was 27 (29.7%) of 91 in laser vs 15 (17.65%) of 85 no-laser patients (P=.061). CNV onset was approximately 6 months earlier in laser-treated compared with no-laser patients (P=.05). In the bilateral group, vision loss occurred in six (8.3%) of 72 laser-treated vs 10 (13.9%) of 72 fellow eyes (P=.3877). CNV incidence was 12 (11.6%) of 103 in laser-treated vs seven (6.8%) of 103 fellow eyes (P=.225). There was no difference in onset of CNV.
Results do not support prophylactic laser of the fellow eye of patients with neovascular ARM. Its role in patients with bilateral drusen remains unclear.
玻璃膜疣激光研究评估了黄斑激光治疗在预防高危年龄相关性黄斑病变（ARM）中脉络膜新生血管（CNV）形成及视力丧失方面的效果。
在五个医院中心进行的前瞻性、干预性、随机对照临床试验。
单侧组患者研究眼患有新生血管性ARM和玻璃膜疣。研究眼被随机分为激光治疗组或非激光治疗组。对于双侧玻璃膜疣组患者，眼睛被随机分为右眼接受激光或不接受激光治疗；左眼则相反。激光治疗包括12个氩激光光斑。观察指标为最佳矫正视力和CNV体征，持续监测3年。
在单侧组中，73例接受激光治疗的患者中有21例（28.8%）出现视力丧失，而66例未接受激光治疗的患者中有13例（19.7%）出现视力丧失（P = 0.214）。91例接受激光治疗的患者中有27例（29.7%）发生CNV，而85例未接受激光治疗的患者中有15例（17.65%）发生CNV（P = 0.061）。与未接受激光治疗的患者相比，接受激光治疗的患者CNV发病时间提前约6个月（P = 0.05）。在双侧组中，72例接受激光治疗的患者中有6例（8.3%）出现视力丧失，而72例对侧眼中有10例（13.9%）出现视力丧失（P = 0.3877）。接受激光治疗的103例患者中有12例（11.6%）发生CNV，而103例对侧眼中有7例（6.8%）发生CNV（P = 0.225）。CNV发病时间无差异。
结果不支持对新生血管性ARM患者的对侧眼进行预防性激光治疗。其在双侧玻璃膜疣患者中的作用仍不明确。
