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Slowed Progression of Age-Related Geographic Atrophy Following Subthreshold Laser

Authors
  • Luttrull, Jeffrey K1
  • Sinclair, Stephen H2
  • Elmann, Solly3
  • Chang, David B4
  • Kent, David5
  • 1 Ventura County Retina Vitreous Medical Group, Ventura, California
  • 2 Sinclair Retina Associates, Media, Pennsylvania
  • 3 Brooklyn Hospital Medical Center, Brooklyn, New York
  • 4 Retinal Protective Sciences, LLC, Ojai, California
  • 5 The Eye Clinic, Kilkenny, Ireland 6. University of Liverpool, Liverpool
Type
Published Article
Journal
Clinical Ophthalmology (Auckland, N.Z.)
Publisher
Dove
Publication Date
Oct 01, 2020
Volume
14
Pages
2983–2993
Identifiers
DOI: 10.2147/OPTH.S268322
PMID: 33061284
PMCID: PMC7534850
Source
PubMed Central
Keywords
License
Green

Abstract

Purpose To determine the effect of panmacular low-intensity/high-density subthreshold diode micropulse laser (SDM) on age-related geographic atrophy (ARGA) progression. Methods The retinal images of all eyes with ARGA in a previously reported database, consisting of all eyes with dry age-related macular degeneration (AMD) active in a vitreoretinal practice electronic medical record (EMR), were identified and analyzed to determine the velocity of radial linear ARGA progression during observation and after panmacular SDM. Results Sixty-seven eyes of 49 patients with ARGA, mean age of 86 years were identified as having follow-up both before and after initiation of SDM treatment. All were included in the study. These eyes were followed a mean 910 days (2.5 years) prior to SDM treatment and a mean 805 days (2.2 years) after. Measurement masked to treatment vs observation found the radius of ARGA lesions progressed 1 to 540 µm per year (mean 137µm, SD 107) prior to treatment (controls); and −44 to 303 µm per year (mean 73µm, SD 59) after initiation of periodic panmacular SDM laser. Thus, the velocity of radial linear progression decreased 47% per year following panmacular SDM (p<0.0001). There were no adverse treatment effects. Conclusion In cohort of eyes with high-risk dry AMD, panmacular SDM slowed linear radial ARGA progression velocity 47% per year (p<0.0001) without adverse treatment effects. Validated, these findings would constitute an important advance in the prevention of age-related visual loss and a benchmark for future therapies.

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