Abstract
Purpose: :
Copaxone (Glatiramer acetate) has been recently used to treat dry AMD patients resulting in a reduction of total drusen area measured on color fundus photos in Copaxone treated versus sham treated patients. Using high resolution spectral domain optical coherence tomography (SD-OCT), it is possible to analyze various morphologic parameters of drusen such as shape, internal reflectivity, homogenicity, and presence of overlying foci of hyper-reflectivity.Our purpose was to determine which drusen parameters are more likely to result in drusen shrinkage or disappearance in Copaxone treated dry AMD patients.
Methods: :
Subjects with a clinical diagnosis of dry AMD were enrolled in the study. The subjects received either Copaxone or sham cutaneous injections weekly for 12 weeks. SD-OCT images were obtained prior to treatment and after 12 weeks of therapy to analyze morphologic parameters of drusen within the macular region. Pre and post treatment drusen were compared.
Results: :
26 eyes of dry AMD patients were included in the study of which 14 eyes (7 patients) were treated with Copaxone and 12 eyes (7 patients) received sham treatment. Overall, between baseline and after 12 weeks of treatment, the percentage of drusen which disappeared/shrank in the Copaxone treated group was 19.1% versus 6.5% in the sham treated group (p=0.13). Convex shape and low/medium internal reflectivity were found to be favorable parameters in prediction of drusen reduction in Copaxone treated patients.
Conclusions: :
Dry AMD patients may benefit from Copaxone treatment which may result in drusen reduction. Drusen patterns demonstrating convex shape and low/medium internal reflectivity tend to shrink or disappear after Copaxone treatment. Further investigation is needed in order to determine statistical significance.
Clinical Trial: :
www.clinicaltrials.gov NCT00466076
Keywords: age-related macular degeneration • drusen