June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Uniocular peripheral retinal laser stabilizes AMD visual outcomes binocularly
Author Affiliations & Notes
  • Danny H.- Kauffmann Jokl
    Columbia University Irving Medical Center, New York, New York, United States
    Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
  • R Theodore Smith
    New York Eye and Ear Infirmary of Mount Sinai Ophthalmology, New York, New York, United States
  • Rando Allikmets
    Columbia University Irving Medical Center, New York, New York, United States
  • Sankha Amarakoon
    Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
  • weijia fan
    Columbia University Irving Medical Center, New York, New York, United States
  • mihai busuioc
    Columbia University Irving Medical Center, New York, New York, United States
  • Suzanne Yzer
    Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
  • jan van meurs
    Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
  • Footnotes
    Commercial Relationships   Danny Jokl, None; R Theodore Smith, None; Rando Allikmets, None; Sankha Amarakoon, None; weijia fan, None; mihai busuioc, None; Suzanne Yzer, None; jan van meurs, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 280. doi:
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      Danny H.- Kauffmann Jokl, R Theodore Smith, Rando Allikmets, Sankha Amarakoon, weijia fan, mihai busuioc, Suzanne Yzer, jan van meurs; Uniocular peripheral retinal laser stabilizes AMD visual outcomes binocularly. Invest. Ophthalmol. Vis. Sci. 2021;62(8):280.

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

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Abstract

Purpose : Purpose: Can uniocular, peripheral retinal laser influence AMD vision outcome long term?

Methods : Methods: 14 patients with AMD with IRB approval (Rotterdam, The Netherlands (ISRCTN 967546)- and baseline vision (20/20-20/40 OU), consented to uniocular, 200 argon laser 200µ spots at 200 mV to the superior temporal retina, with the untreated eye as control. At termination, binocular changes in drusen volume and visual acuity were observed. In place of a control, AREDS AAMD long term visual outcomes were used.
11/14, patients, (5 M, 6F; ages 58-83), 3 patients had deceased, were examined a mean of 58 months (12-74 months) with digital fundus photos and drusen images. DNA of 11/14 patients was analyzed for ARMS2 and CFH with AMD-associated SNPs. Masked clinical and genetic data were correlated.

Results : At a significance level of 0.05 - a significant interaction beneficial effect between increasing time from the initial laser treatment was found.
In the treated eye, coefficient for time was 0.0013 ( p=0.0016) - for every month increase, the average VA increases by 0.0013 units, adjusting for eyes (whether it’s the right eye or the left eye).
In the control eye, coefficient for time was 0.0040 (p-value < 0.0001) - for every month increase, the average VA increases by 0.0040 units.
- 64% of the cohort displayed little visual loss after 10 years;
- 27% had uniocular visual loss;
- 9% (one case) had bilateral visual loss.
The two genetic risk alleles showed no correlation with the final visual acuity.
Uniocular retinal laser had a binocular effect on vision outcomes:
91% (10/11subjects) maintained baseline visual acuity in one or both eyes.visual acuity in one or both eyes.
A significant interaction between treatment and time (p=0.0028), with better VA for the treated eye was found.

Conclusions : In the presence of alleles for ARMS2 and CFH, functional long term binocular visual outcomes compared favorably to AREDS AAMD long term visual acuity findings,
The mean net change in drusen area in the treated (resp., control) eye was +1.5 resp., -1.1) mm sq, was not significant (paired t test (p= 0.13).
- These serendipitous findings suggests a systemic immune system activation to inflammation induced by uniocular retinal laser.
- Despite limitations of a pilot study, confirmation from a larger controlled study is warranted.

This is a 2021 ARVO Annual Meeting abstract.

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