Back to Journals » Clinical Ophthalmology » Volume 14

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


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

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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]