Abstract
Purpose :
Preliminary work has shown that levodopa, a dopamine agonist prescribed for Parkinson disease and other movement disorders, is protective against development and progression of age-related macular degeneration (AMD), but little data exists characterizing the effects of other dopamine agonists (DA) on AMD. We performed a retrospective clinical study to compare the effects of other DA to levodopa on AMD development and progression.
Methods :
This was a retrospective study of 21 patients with a history of AMD and levodopa or other DA use over a 3-year follow-up period. Patients were excluded if drug therapy was for less than 6 months. Medical records were reviewed for demographic data, best corrected visual acuity (BCVA), and characteristics of levodopa/DA use. Optical coherence tomography (OCT) images were analyzed for presence of choroidal neovascularization (CNV) or geographic atrophy (GA), as well as quantification of central macular thickness (CMT).
Results :
A total of 39 eyes from 21 patients were analyzed. The levodopa cohort (LC) consisted of 14 eyes from 7 patients and the different DA cohort (DAC) consisted of 25 eyes from 14 patients. Other DA included ropinirole, pramipexole, bupropion, amantadine, and bromocriptine. Drug therapy preceded AMD diagnosis in 2 LC eyes (14.3%) and 6 DAC eyes (24.0%): mean time from diagnosis to initiation of treatment was 2.7 years in LC and 0.9 years in DAC. Treatment duration was 3.4 years in LC and 4.0 years in DAC. Age at AMD diagnosis was higher in LC patients than DAC patients (80.3 vs 74.6 years, p=0.10). Baseline BCVA was 20/50 in each cohort. DAC eyes had higher rates of CNV (52.0% vs 0.0%, p<0.01) and GA (24.0% vs 0.0%, p=0.12) at baseline. At 3-year follow-up, BCVA was better in LC patients compared to DAC patients (20/35 vs 20/75, p=0.29). Over the 3-year follow-up period, dry AMD to wet AMD conversion was noted in 4 and 5 eyes in the LC and DAC, respectively. GA developed in 4 (28.6%) LC eyes and 3 (15.8%) DAC eyes.
Conclusions :
Patients with AMD taking levodopa had improved visual outcomes over a 3-year follow-up period compared to patients taking different DA. Progression of AMD to more severe dry AMD or wet AMD varied between cohorts. Follow-up investigation with a larger sample size is warranted to ascertain the comparative effects of levodopa and other dopamine agonists on AMD.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.