The proposed Foveal Photocoagulation Study is a multicenter study of treatment for age-related degeneration (AMD) in eyes with subfoveal neovascular lesions. The study consists of two randomized controlled trials of laser photocoagulation treatment and a natural history study of eyes ineligible for the trials. Eligible AMD patients who meet the visual acuity criteria for the randomized trials (20/80 greater than VA greater than 20/320) will be assigned to treatment or to no treatment of the neovascular lesion. Natural history study patients will have AMD and a subfoveal neovascular lesion but visual acuity better than 20/80. The purpose of the randomized trials is to determine whether krypton red laser photocoagulation is effective in preventing or delaying severe loss of vision in AMD patients who have subfoveal lesions, whether these are new neovascular lesions or recurrent neovasculrization subfoveally following prior treatment for extrafoveal or jextafoveal lesions. The purpose of the natural history study is to determine the rate at which visual acuity deteriorates to 20/80 or worse in eyes with AMD and subfoveal neovascular membranes after initial clinical presentation of patients who would otherwise be eligible for the randomized trials. This study will be carried out in twelve Clinical Center, a Coordinating Center, and a Fundus Photograph Reading Center; the study investigators and centers are those who have collaborated in the Macular Photocoagulation Study (MPS) over the past six years. This proposal is submitted to obtain funding for the Coordinating Center for the multicenter study. The role of the Coordinating Center will be similar to the role of that center in the Macular Photocoagulation Study, and methodology is directly transferrable from the MPS to the proposed study. The Coordinating Center has been structured to build on the staff experiences and systems developed for the MPS.
