Foveal drusen resorption one year after perifoveal laser photocoagulation

"Soft" drusen maculopathy is an important precursor of exudative and atrophic macular degeneration. Resorption of soft drusen at the macula in response to laser photocoagulation has been demonstrated previously. The case described in this article is unique because it documents progression of soft drusen maculopathy prior to laser and shows a better visual and morphologic result than in previous studies. In this case, perifoveal laser photocoagulation caused the complete resorption not only of the treated drusen but also the untreated subfoveal and perifoveal drusen. Foveal morphology was restored, visual acuity improved from 20/40 to 20/20, and metamorphopsia diminished. This uniquely favorable response to photocoagulation may result from the treatment of the drusen maculopathy before atrophic, exudative, or neovascular complications. This result shows the need for establishing indications for this treatment through a prospective clinical study and for investigating its mechanism of action.