Topical brimonidine reduces collateral damage caused by laser photocoagulation for choroidal neovascularization

To evaluate the neuroprotective efficacy of brimonidine applied topically to the eyes of patients undergoing laser treatment for extrafoveal or juxtafoveal choroidal neovascularization (CNV). In this prospective, controlled, double-masked pilot study, 20 eyes were randomized to receive either brimonidine 0.2% (study group, 11 eyes) or placebo (matched control group, 9 eyes). Medications were topically applied twice a day during a period of 4-48 h before laser treatment and were continued for 1 month. Two eyes in each group had severe visual loss owing to recurrence of CNV. In the remaining 16 eyes there was a significant improvement in the study group, but no improvement in the control group (P=0.027). Topical brimonidine improves the visual outcome of laser-treated classic extrafoveal or juxtafoveal CNV, possibly by protecting the neuroretina against collateral damage caused by the laser treatment.