Grid laser treatment of occult choroidal neovascularization in age related macular degeneration

Laser photocoagulation treatment of occult choroidal neovascularization (CNV) in age related macular degeneration has been up to now discouraging. We report a randomized clinical trial comparing 'grid' laser treatment versus the natural course in 24 eyes with this kind of neovascularization. In 12 eyes a low energy scatter photocoagulation was applied to the areas of presumed CNV and abnormal retinal pigment epithelium, sparing the fovea. The follow-up ranged from 1 to 3 years. At the three months follow-up visit, the subretinal exudation appeared reduced in 40% of the treated eyes and in none of the control eyes. During the period of follow-up the occult CNV turned to classic CNV in 4 treated and in 4 untreated eyes. At the last examination (average follow-up 18 months), anatomical and functional conditions were not significantly different in the two groups. Our data fail to show a beneficial long-term effect of grid laser treatment for occult CNV; no iatrogenic complications were seen in our series.