Posters

Reduced risk of choroidal neovascularization following subthreshold diode micropulse laser (SDM) retinal protective therapy (RPT) for dry age-related macular degeneration

Poster Details

First Author: J.Luttrull USA

Co Author(s):    S. Elmann   B. Glaser                          

Abstract Details



Purpose:

To determine the incidence of new choroidal neovascularization (CNV) following panmacular subthreshold diode micropulse laser (SDM) as retinal protective therapy (RPT) in dry age-related macular degeneration (AMD).

Setting:

A private vitreoretinal subspeciality practice (JKL).

Methods:

In an observational retrospective cohort study, the electronic medical records database (EMR) records of all active patients in a private vitreoretinal practice having undergone SDM RPT for dry AMD were reviewed, classified by AREDS categories, and analyzed for the primary endpoint of new CNV after treatment.

Results:

Treatment was offered to 305/326 (94%) treatment candidates during the study period, and elected by 296 (97%). Postoperative follow up (avg. 20 mos) was available for 290 treated patients (432 eyes, 98%). Risk factors for CNV included age (avg. 83 years, 68% over 80); high prevalence of reticular pseudodrusen (RPD) (158 eyes, 37%); high AREDS severity (77% category 3 and 4); and high prevalence fellow eye CNV (118 eyes, 27%). Without adjusting for these risk factors, the incidence of new CNV was 7/432 (1.6%, annualized rate 0.97%). RPD and fellow eye CNV increased the risk of CNV post SDM RPT (p=0.02, each). Systemic hypertension lowered the risk (p=0.048). For eyes completing 12 months follow up, there were 4 progressions in 4963 person-eye months (0.81 progressions per 1,000 person-eye months). For eyes completing 24 months follow up, there were 6 progressions in 7635 total person-eye months (0.79 progressions per 1000 person-eye months). Visually acuity (VA) was stabilized. There were no adverse treatment effects.

Conclusions:

In a high-risk population, SDM RPT markedly reduced the risk of new CNV in dry AMD and stabilized VA, without adverse treatment effects. SDM RPT may offer a new, safe, and highly effective method of reducing the risk of vision loss in patients with dry AMD.

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