Gross-Jendroska M, Owens S L, Flaxel C J, Guymer R H, Bird A C
Department of Clinical Ophthalmology, Institute of Ophthalmology, University of London, Moorfields Eye Hospital, United Kingdom.
Am J Ophthalmol. 1998 Jul;126(1):77-81. doi: 10.1016/s0002-9394(98)00061-0.
To evaluate prophylactic laser treatment of the macula in reducing the risk of visual loss in the fellow eye of patients with a retinal pigment epithelial tear caused by age-related macular degeneration in the first eye.
In a prospective study, 12 patients with a retinal pigment epithelial tear in one eye caused by age-related macular degeneration and drusen in the fellow eye received prophylactic laser treatment of the retina in their fellow eyes and were followed up for 2 years or more after prophylactic treatment.
In 12 fellow eyes that received prophylactic laser treatment, a reduction in best-corrected visual acuity to 20/80 or worse occurred in one (8%) of 12 eyes in the first year and two (18%) of the remaining 11 eyes in the second year after treatment. The cumulative risk of visual loss in the treated fellow eye was 25% in 2 years.
In historical control subjects in a natural history study of patients with retinal pigment epithelial tear in one eye, central visual loss occurred in 16 (37%) of 43 eyes in the first year and in seven (30%) of 23 eyes in the second year for a cumulative loss of 59% in the first 2 years. Compared with these historical control subjects, our findings suggest that visual loss in the fellow eyes of patients with a retinal pigment epithelial tear in the first eye is reduced by prophylactic low intensity laser photocoagulation of the macula.
评估对黄斑进行预防性激光治疗，以降低第一眼因年龄相关性黄斑变性导致视网膜色素上皮撕裂的患者对侧眼视力丧失的风险。
在一项前瞻性研究中，12例一眼因年龄相关性黄斑变性导致视网膜色素上皮撕裂且对侧眼有玻璃膜疣的患者，对其对侧眼进行视网膜预防性激光治疗，并在预防性治疗后随访2年或更长时间。
在接受预防性激光治疗的12只对侧眼中，治疗后第一年12只眼中有1只（8%）最佳矫正视力降至20/80或更差，第二年剩余11只眼中有2只（18%）最佳矫正视力降至20/80或更差。治疗后对侧眼2年内视力丧失的累积风险为25%。
在一项单眼视网膜色素上皮撕裂患者自然史研究的历史对照受试者中，第一年43只眼中有16只（37%）出现中心视力丧失，第二年23只眼中有7只（30%）出现中心视力丧失，头2年累积视力丧失率为59%。与这些历史对照受试者相比，我们的研究结果表明，对第一眼有视网膜色素上皮撕裂的患者的对侧眼进行黄斑预防性低强度激光光凝可降低视力丧失的风险。
