Five-year follow-up of fellow eyes of patients with age-related macular degeneration and unilateral extrafoveal choroidal neovascularization. Macular Photocoagulation Study Group

Arch Ophthalmol. 1993 Sep;111(9):1189-99. doi: 10.1001/archopht.1993.01090090041018.


Objectives: To assess the visual prognosis of patients with age-related macular degeneration and unilateral extrafoveal choroidal neovascularization (CNV), and to determine the risk of CNV developing in fellow eyes that were initially unaffected.

Design, patients, and setting: Five-year prospective follow-up study of fellow eyes of 228 patients enrolled in a randomized clinical trial of laser photocoagulation of extrafoveal CNV. Visual acuity was measured and macular photographs were taken at 6-month intervals.

Main outcome measures: Five-year change in visual acuity of fellow eyes from baseline, incidence of legal blindness (visual acuity of < or = 20/200 in the better eye), and cumulative incidence of CNV in fellow eyes free of neovascular maculopathy at the time of study enrollment.

Results: Photographically documented CNV developed in 33 (26%) of 128 fellow eyes that were initially free of neovascular maculopathy, and was associated with poor visual acuity at the end of the 5-year follow-up period. Among 67 patients who had bilateral neovascular maculopathy initially and were examined 5 years later, 33 (49%) were legally blind compared with 13 (12%) of 106 patients who had unilateral neovascular maculopathy initially. In all 13 of the latter group, CNV had developed in the fellow eye.

Conclusions: Patients with age-related macular degeneration and CNV in one eye are at high risk of legal blindness within 5 years, and, thus, should be followed up carefully to ensure that laser treatment can be applied to CNV in either eye whenever it is likely to improve the visual prognosis.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blindness / etiology
  • Choroid / blood supply*
  • Choroid / pathology
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fovea Centralis / pathology*
  • Fundus Oculi
  • Humans
  • Incidence
  • Longitudinal Studies
  • Macular Degeneration / complications*
  • Macular Degeneration / pathology
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / complications*
  • Neovascularization, Pathologic / pathology
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Visual Acuity