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Evidence summaries

Laser Treatment of Drusen to Prevent Progression to Advanced Age-Related Macular Degeneration

Laser photocoagulation of drusen appears no to reduce the risk of developing choroidal neovascularisation, geographic atrophy, or visual acuity loss. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 9 studies with a total of 2216 subjects; 4 unilateral trials, 3 bilateral trials and 2 trials that included both a unilateral and a bilateral study arm. Although 2/9 studies reported significant drusen disappearance at 2 years, photocoagulation did not appear to affect the development of choroidal neovascularisation (CNV) at 2 years follow up (OR 1.04, 95% CI 0.71 to 1.51; 9 studies, n=1767) or the loss of 3 or more lines of visual acuity (OR 1.17, 95% CI 0.75 to 1.82; 6 studies, n=1628). Data on the development of atrophy could be extracted from only two small studies; no benefit or harm using photocoagulation could be demonstrated regarding this outcome (OR 1.30, 95% CI 0.38 to 4.51; 2 studies, n=66).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).

    References

    • Parodi MB, Virgili G, Evans JR. Laser treatment of drusen to prevent progression to advanced age-related macular degeneration. Cochrane Database Syst Rev 2009;(3):CD006537. [PubMed]

Primary/Secondary Keywords