July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Subthreshold Laser Treatment for Drusenoid Pigment Epithelial Detachment in Intermediate AMD, a 12-month interim analysis
Author Affiliations & Notes
  • Min Seok Kim
    Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)
  • Na-Kyung Ryoo
    Department of Ophthalmology, Veterans Health Service Medical Center, Seoul, Korea (the Republic of)
  • Ji Yeon Park
    Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)
  • Kyu Hyung Park
    Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)
  • Footnotes
    Commercial Relationships   Min Seok Kim, None; Na-Kyung Ryoo, None; Ji Yeon Park, None; Kyu Hyung Park, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1161. doi:https://doi.org/
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      Min Seok Kim, Na-Kyung Ryoo, Ji Yeon Park, Kyu Hyung Park; Subthreshold Laser Treatment for Drusenoid Pigment Epithelial Detachment in Intermediate AMD, a 12-month interim analysis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1161. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : This study aimed to evaluate the efficacy and safety of subthreshold laser photocoagulation for drusenoid pigment epithelial detachment (PED) patients with intermediate AMD, those effective interventions to prevent progression was currently not available.

Methods : A prospective, randomized case-control trial was conducted in patients with bilateral drusenoid PED. Treatment-naïve eyes with a visual acuity of ≤83 ETDRS letters were enrolled. The eye with lower vision (or random selection in case of same visual acuity) was assigned to the laser treatment group, and the fellow eye served as a control group. The laser treatment group received PASCAL subthreshold laser along the periphery of the drusen. To prevent complications such as choroidal neovascularization (CNV), intravitreal Bevacizumab injections were performed on a 3 month interval up to one year. Anatomical outcomes (drusen area, PED height and presence of GA or CNV) and functional outcomes (best corrected visual acuity [BCVA], contrast sensitivity, degree of metamorphopsia and VFQ-25) were analyzed.

Results : A total of 21 patients (mean age 72.6 years) with bilateral drusenoid PED were enrolled. This 12-month interim analysis was done in the 15 patients who satisfied the one-year follow-up period. Mean BCVA change was 3.26 letters in the laser group and 0.47 letters in the control group(p=0.007, 0.602, respectively). Drusen area and PED height decreased significantly in the laser group at month 12 (57.2%, p<0.001; 76.9%, p<0.001, respectively), while no significant change appeared in the control group except increase of PED height in month 9 (110.1%, p=0.10). All other functional parameters besides BCVA showed no significant changes during the follow up visits in both eyes. As for safety, one study eye developed retinal pigment epithelial tear at month 12, and one control eye developed retinal angiomatous proliferation at month 6.

Conclusions : Subthreshold laser photocoagulation in combination with anti-VEGF injections in eyes with drusenoid PED improves functional and anatomical outcomes without serious complication. Larger, randomized long term clinical trials should be followed to clarify the effect of this treatment protocol for intermediate AMD.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Serial fundus photograph and OCT images from the left laser eye (upper two row) and right control eye (lower two row) of a 69-year-old female patient.

Serial fundus photograph and OCT images from the left laser eye (upper two row) and right control eye (lower two row) of a 69-year-old female patient.

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