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Effect of CAPT Laser Treatment on Choroidal Hemodynamics in Age–Related Macular Degeneration (AMD)

Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA

Commercial Relationships: J.E. Grunwald, None; M. Figueroa, None; T.I. Metelitsina, None; L.S. Schocket, None; J.C. DuPont, None.

Grant Identification: Support: NIH grants EY 12769, EY 12279, RPB, and the Vivian S. Lasko Research Fund.

Abstract

Purpose: To determine whether low–intensity laser photocoagulation treatment applied according to the Complications of Age–Related Macular Degeneration Prevention Trial (CAPT) protocol has an effect on the choroidal circulation that may help explain the mechanism leading to the resolution of drusen material.

Methods: This ancillary study included 30 CAPT patients with bilateral drusen that were treated and followed at the University of Pennsylvania clinical center. Laser Doppler flowmetry (Oculix) was used to measure relative choroidal blood velocity, volume, and flow in the center of the fovea. Measurements were obtained through a dilated pupil in both eyes of each patient at the initial CAPT visit before photocoagulation was applied in one eye. Measurements were repeated in both eyes at 3 months (N=30) and 28 months (N=23). Analysis of laser Doppler flowmetry was performed in a masked fashion. Circulatory measurements are shown in arbitrary units (AU).

Results: Average choroidal blood flow at baseline, 3 months, and 28 months were 7.3 ± 2.0 (±1 SD), 7.3 ± 2.5, and 6.8 ± 2.7 AU in the control eyes and 6.8 ± 1.8, 7.0 ± 2.3, and 7.8 ± 3.0 AU in the treated eyes. At 3 months, there was no significant change in choroidal blood flow from baseline in either control or treated eyes. In comparison to control eyes, however, treated eyes showed a 24% increase in choroidal blood flow at 28 months (ANOVA, P =0.04).

Conclusions: Our results suggest an increase in choroidal blood flow 28 months after laser treatment according to the CAPT protocol. This increase may have a role in the mechanism leading to disappearance of drusen following photocoagulation.

Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • drusen

© 2004, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any part of this abstract, contact the ARVO Office at arvo{at}arvo.org.