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Slowed Progression of Age-Related Geographic Atrophy Following Subthreshold Laser

Authors Luttrull JK, Sinclair SH, Elmann S, Chang DB, Kent D

Received 27 June 2020

Accepted for publication 12 August 2020

Published 1 October 2020 Volume 2020:14 Pages 2983—2993

DOI https://doi.org/10.2147/OPTH.S268322

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser


Jeffrey K Luttrull,1 Stephen H Sinclair,2 Solly Elmann,3 David B Chang,4 David Kent5

1Ventura County Retina Vitreous Medical Group, Ventura, California, USA; 2Sinclair Retina Associates, Media, Pennsylvania, USA; 3Brooklyn Hospital Medical Center, Brooklyn, New York, USA; 4Retinal Protective Sciences, LLC, Ojai, California, USA; 5The Eye Clinic, Kilkenny, Ireland 6. University of Liverpool, Liverpool, UK

Correspondence: Jeffrey K Luttrull
Ventura County Retina Vitreous Medical Group, 3160 Telegraph Road, Suite 230, Ventura, California 93003, USA
Tel +1 805-650-0664
Email jkluttrull@gmail.com

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.

Keywords: age-related macular degeneration, laser, micropulse, subthreshold, sublethal, geographic atrophy, progression, heat-shock proteins, reset, prevention, reticular pseudodrusen

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