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Slowed Progression of Age-Related Geographic Atrophy Following Subthreshold Laser

  • 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
Published Article
Clinical Ophthalmology (Auckland, N.Z.)
Publication Date
Oct 01, 2020
DOI: 10.2147/OPTH.S268322
PMID: 33061284
PMCID: PMC7534850
PubMed Central


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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