Article

Laser treatment in CAPT neither beneficial nor harmful

Author(s):

Las Vegas-Laser treatment as applied in the Complications of Age-Related Macular Degeneration Prevention Trial (CAPT) proved to be neither beneficial nor harmful after 5 years of follow-up when compared with eyes that were observed for that period, Stuart Fine, MD, reported at the American Academy of Ophthalmology (AAO) annual meeting.

The CAPT, a 22-site prospective study that was supported for 8 years by the National Eye Institute, was born out of the desire to determine whether low-intensity laser treatment could decrease the incidence of vision loss in patients with large high-risk drusen in both eyes. The CAPT investigators reported their findings in the November issue of Ophthalmology (2006;113:1974-1986).

To participate in the study, patients satisfied the following criteria: the presence of more than 10 large drusen (exceeding 125 µm) in each eye, visual acuity better than 20/40 in each eye, aged more than 50 years, and the presence of no other ocular disease that could interfere with assessment of the visual outcome, Dr. Fine said.

A total of 1,052 patients participated in the study, and they were followed for at least 5 years. The primary outcome measure was a change in visual acuity, and the secondary outcome measures were the incidence of late AMD, contrast thresholds, reading vision, and the side effects of treatment, according to Dr. Fine.

Only 3% of the follow-up visits were missed over the 5- to 6-year follow-up; 87% of patients completed the 5-year examination, with only 42 living patients missing the 5-year visit.

An important finding in the study, according to Dr. Fine, was that "laser-treated eyes were far more likely to experience a 50% or greater reduction in baseline drusen compared with the observed eyes."

A loss of visual acuity that exceeded 3 or more lines was the principal outcome of interest.

"At the 5-year visit, 21% of eyes treated with laser and observed eyes lost 3 or more lines of vision," he said. At 6 years, that percentage for both groups increased to 24%. This lack of a difference in visual outcomes is similar to what had been reported at the 2005 AAO meeting by Thomas Friberg, MD, and colleagues for the Prophylactic Treatment of Age-Related Macular Degeneration Study Group, Dr. Fine pointed out. This study was reported in the April issue of Ophthalmology (2006;113:612-622).

In the study under discussion, the incidence of late AMD continued to increase with each passing year but did not differ between treated and observed eyes. At 5 years, 20% of treated eyes and 20% of observed eyes developed late AMD. Similarly, the incidence of choroidal neovascularization (CNV) did not differ between treated and observed eyes. At 5 years, 13% of eyes in each group had developed CNV. In addition, the incidence of geographic atrophy at 5 years was identical in treated and observed eyes, 7.5%. The mean visual acuity at the first visit was 20/25 + 2, and at the 5-year follow-up visit, it was 20/40 +3. The mean visual acuity lost over the 5-year period was about 2 lines. At baseline, 50% of the eyes had 20/20 or better visual acuity, and at 5 years only 31% had that level of vision, according to Dr. Fine.

Newsletter

Don’t miss out—get Ophthalmology Times updates on the latest clinical advancements and expert interviews, straight to your inbox.

Related Videos
Steven R. Sarkisian, Jr., MD, ABO, speaks about glaucoma at the 2025 ASCRS annual meeting
(Image credit: Ophthalmology Times) ASCRS 2025: Eric D. Donnenfeld, MD, on the effect of lifitegrast clinical signs and biomarkers in dry eye disease
(Image credit: Ophthalmology Times) The Residency Report: Clinical insights from the iStent infinite trial
(Image credit: Ophthalmology Times) ASCRS 2025: Amar Shah, MD, on why hyperosmolar tear film before and after cataract surgery matters
© 2025 MJH Life Sciences

All rights reserved.