Abstract
Purpose :
Recent studies have revealed intriguing connections between two seemingly disparate neurodegenerative disorders--Parkinson’s disease (PD) and age-related macular degeneration (AMD)--raising the question of whether there exists a potential therapeutic intersection between the two. Dopamine, a key modulator in brain health (supplemented as levodopa in PD), is also secreted by retinal amacrine cells and may play a multifaceted role in the human body by influencing retinal health. This retrospective cohort analysis examines the impact of dopaminergic therapies on progression from early/intermediate AMD to advanced non-exudative AMD with geographic atrophy.
Methods :
Utilizing the Duke Enterprise Data Unified Content Explorer (DEDUCE), a ten-year retrospective cohort analysis was conducted on patients diagnosed with AMD by optical coherence tomography (OCT). Eyes with an initial early/intermediate AMD diagnosis by OCT and at least one year of follow-up were included in this study. Eyes from these individuals were categorized into three groups: 1) eyes not exposed (NE) to dopaminergic therapies, 2) eyes exposed to levodopa (LD) prior to advanced AMD diagnosis, and 3) eyes exposed to non-levodopa (NL) dopaminergic therapies (DT) before advanced AMD diagnosis. Eyes were then evaluated for risk of progression from early/intermediate to advanced AMD using generalized estimating equations (GEEs) to adjust for covariates.
Results :
Of the 3,048 eyes from 1,581 individuals with an initial diagnosis of early/intermediate AMD by OCT, 2,946 were NE to DT, 37 were on LD, and 65 were on NL-DT. Notably, 7.8% of eyes NE to DT progressed to advanced, 0% of eyes on LD progressed to advanced, and 3.1% of eyes on NL-DT progressed to advanced. Taken together, 1.9% of eyes on any DT progressed to advanced AMD. GEE modeling revealed the risk of progression to advanced AMD was significantly reduced by 79% (p = 0.031) when DT was initiated prior to advanced AMD diagnosis.
Conclusions :
DT initiated in patients with a diagnosis of early/intermediate AMD decreased the risk of progression to advanced AMD. While dopamine deficiency is linked to PD, our findings suggest a potential shared mechanism between two neurodegenerative disorders, highlighting the potential role of dopaminergic modulation in reducing the risk of progression to advanced AMD.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.