Author/Editor     Lenassi, Eva; Troeger, Eric; Wilke, Robert; Tufail, Adnan; Hawlina, Marko; Jeffery, Glen; Webster, Andrew R
Title     Laser clearance of drusen deposit in patients with autosomal dominant drusen (p.Arg345Trp in EFEMP1)
Type     članek
Source     Am J Ophthalmol
Vol. and No.     Letnik 155, št. 1
Publication year     2013
Volume     str. 190-8
Language     eng
Abstract     Purpose: To assess whether laser treatment to the retinal pigment epithelium anterior to drusen in eyes of patients with EFEMP1-related maculopathy affects visual acuity, deposit volume, and retinal sensitivity. DESIGN: Prospective, interventional case series. Methods: In 11 patients with autosomal dominant drusen and confirmed disease-causing EFEMP1 mutation, the worse-seeing eye was treated with Argon green laser (10 to 15 laser spots; 200-mum spot size, 0.1-second duration, 80 to 120 mW). Patients were examined before treatment as well as 1, 3, 6, and 12 months after the procedure. Clinical assessment included visual acuity, fundus-controlled perimetry, spectral-domain optical coherence tomography, and autofluorescence imaging. Custom-made software allowed for coregistration of fundus-controlled perimetry and spectral-domain optical coherence tomography data sets. The main outcome measures were change in visual acuity, retinal sensitivity, and drusen volume. Results: The untreated eyes lost an average of 0.8 letters, whereas the treated eyes gained an average of 4.9 letters. For fundus-controlled perimetry, locus-by-locus differences in sensitivity were calculated between pretreatment and posttreatment assessments; subsequently, the overall difference in the treated and untreated eye was compared. Five patients showed significant improvement in retinal sensitivity, 5 patients showed no change, and 1 patient showed significant deterioration. An increase in mean drusen thickness was observed in the untreated eyes, but not in the treated eyes (P = .0322). The thickness of the drusen correlated with retinal sensitivity (rho = -0.49; P < .0001). Safety was demonstrated and no adverse events were observed. Conclusions: Low-energy laser treatment is safe and may be effective in the treatment of autosomal dominant drusen. Further evaluation with long-term assessment is required to confirm the benefits.
Descriptors     RETINAL DRUSEN
LASER COAGULATION
FLUORESCENCE
PERIMETRY
VISUAL ACUITY
TOMOGRAPHY
OPHTHALMOSCOPY