Laser photocoagulation for treating choroidal new vessels near the centre of the retina in people with high myopia

In people with high myopia (refractive error -6 diopters or worse) new blood vessels can grow under the retina of the eye (choroidal neovascularisation). For decades laser coagulation has been used to destroy lesions that are not central. This review found one small study, including 70 participants, which compared laser photocoagulation with no treatment for people with this disease. This study was inadequately reported and analysed, although it suggested a benefit with photocoagulation during the first two years of follow up. Another small study compared three laser wavelengths to achieve photocoagulation of the lesion, but actually had very little power to demonstrate a difference between them as only 27 participants were included. Therefore, despite its widespread use for many years, the amount of benefit achieved with photocoagulation and the possibility that it is maintained over the years remains unknown. Furthermore, these and other studies suggest that the enlargement of the laser scar could be a potentially vision-threatening long-term complication after two years, since it may cause the gradual occurrence of a blind spot in the centre of the visual field due to progressive atrophy of the retina.