Abstract
Purpose :
As the eye ages, the permeability of Bruch’s membrane is reduced, inhibiting its ability to remove fluid and waste deposits under the macula known as drusen and pigmentary abnormalities. Currently, approximately 5-25% of patients with dry AMD progress to advanced and exudative AMD, and yet there are few known treatments to prevent the progression. 2RT is a new nanosecond laser technology that selectively targets organelles within the retinal pigment epithelium (RPE) improving Bruch’s permeability and has demonstrated initial results that may be promising, although evidence is limited. The laser uses non-thermal, solid-state, nanosecond laser technology featuring a large 400-micron spot size and 500 times less energy than retinal photocoagulation. We hypothesize that 2RT can decrease drusen size and prevent the progression of dry AMD to exudative AMD.
Methods :
All patients that received 2RT at a community ophthalmology practice were retrospectively reviewed at follow-up periods of 1, 3, 6, and 12 months. The primary outcome was the number of patients that progressed from dry AMD to exudative AMD. Secondary outcome included the change in drusen size. Statistical analysis was completed using Graphpad Prism version 9.0.0.
Results :
A total of 202 eyes from 106 patients were included based on exclusion criteria with an average of 2.6 2RT treatments for a total of 545 treatments. Five (4.5%) patients were excluded as they did not have pre-2RT visual acuity and fundus photos taken to classify their AMD. Average participant age was 77 years (range 62 - 94 years) with 70/106 (66.0%) of patients being female. 22/202 (10.9%) eyes from 15/106 (14.2%) patients had progression in AMD from a baseline in AMD classified of 3.3 (SD +/- 1.0) compared to final AMD of 3.4 (SD +/- 0.8) which was statistically significant (p = 0.0071) with 3 being classified as “Early” AMD with drusen between 63-125 microns, and 4 being “Intermediate” AMD with large drusen or pigmentary changes. No patients progressed to exudative AMD. Data and statistical analysis was performed using a paired t-test completed.
Conclusions :
Patients that received 2RT treatments did not progress to advanced or exudative AMD. However, overall, patients did not see reversal of the AMD classification, and there was still a significant progression in AMD, although the progression may not be clinically significant and may be slower than in untreated patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.