This release summarizes the results of a modest study of the ability of lasers to vaporize eye floaters, which are deposits or condensation in the vitreous, the material that fills the back of the eye. The text briefly captures the outcomes of the study: six months out, patients who received laser treatments reported seeing fewer floaters than did those who received a sham light treatment. It also mentions a couple of study limitations. But it doesn’t mention how much the treatment costs or the risks of a treatment that may be unnecessary for most individuals.
Eye floaters are common; by age 70 almost all individuals have them, although many go unnoticed. In most cases, they are not dangerous and people get accustomed to having them, although their sudden appearance can be disconcerting, sending many individuals to their doctors. News releases about laser interventions, thus, need to tread carefully to avoid over-selling a treatment that is still not well validated and, for most people, would not be necessary in the first place. According to the National Eye Institute: “For people who have floaters that are simply annoying, no treatment is recommended.”
Cost does not make an appearance. Given the ubiquity of these floaters, some reflection on cost is warranted, as laser treatment of both eyes can run into the thousands of dollars.
The release briefly summarizes the results. It states, “A total of 19 patients (53 percent) in the YAG laser group reported significantly or completely improved symptoms vs 0 individuals in the sham group.”
It also notes that both the small sample size and short follow-up period were limitations of the study.
No harms were mentioned in the release. Laser treatment can produce such irritants as “dry eye” and temporary visual halos, and a small number of patients have experienced increased eye pressure and the development of cataracts. These harms are apparently rare, but they deserve attention. The published study noted that there were few adverse effects and they were minor, but that the small sample size and length of follow-up were not adequate to make any firm statement about harms.
While the release could have included much more detail about the sham-controlled, randomized trial design, it at least noted the study’s small sample size and short follow-up period (6 months).
The study excluded patients who had symptoms that were less than six months duration. It would have been good for the release to briefly describe the “natural history” of these floaters and how likely it is that floaters will resolve spontaneously over time. The study design was very good with blinding on the part of patients and masking (a form of blinding) on the part of the physician assessing the follow-up photos looking for floaters.
Cases of eye floaters that need medical intervention occur, but as the release notes, “most patients grow accustomed to them.” Most people adapt to their floaters or the floaters settle at the bottom of the eye — out of the line of sight — without treatment. The release doesn’t note that laser treatments would be relevant in those few serious cases, thus setting the stage for over-use in the majority of cases that would not require treatment.
The release doesn’t name any funders. ClinicalTrials.gov states that Ophthalmic Consultants of Boston sponsored the study. The journal article notes that neither coauthor had conflicts of interest.
The release mentions three treatment options for eye floaters — patient education and observation, surgery, and laser treatment — but didn’t comment on how these treatments compared in effectiveness. That’s probably because the study did not compare laser surgery against other treatments for eye floaters.
The American Association of Opthalmology, as of 2015, viewed the evidence for laser treatment benefits as too limited to offer its official support.
Although wording of the release makes it clear that laser treatments are an option for eye floaters, the release does not provide information about availability.
However, there is enough information in the published study for any ophthalmologist who is skilled in the use of the YAG laser to be able to use the treatment.
The journal article makes the claim that it reflects the first prospective, sham-controlled design of laser intervention for eye floaters, an assertion ignored by the release.
The release is factual and straightforward. Its primary problem is one of omission. It doesn’t note that that data on the effectiveness of this procedure are still limited and that most individuals with eye floaters will not need it.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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