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.