Laser and anti-vascular endothelial growth factor treatment for drusenoid pigment epithelial detachment in age-related macular degeneration.

Abstract

This study aims to report the 12 months results of efficacy and safety of laser photocoagulation and anti-vascular endothelial growth factor (VEGF) injections for drusenoid pigment epithelial detachment (dPED). In this prospective study, patients with treatment naïve bilateral intermediate age-related macular degeneration, featuring dPED, with visual acuity ≤ 83 letters were enrolled. The study group received PASCAL laser (532 nm) along the periphery of the dPED, and the fellow eye served as a control group. To prevent complications of choroidal neovascularization, intravitreal anti-VEGF injections to laser treated eye were performed on a 3-month interval up to 1 year. Primary outcomes-drusen area, PED height-and secondary outcomes-best-corrected visual acuity (BCVA), contrast sensitivity, degree of metamorphopsia, NEI-VFQ 25, and fundus autofluorescence-were analyzed. Among 21 patients, a total of 20 patients satisfied the 12 months follow-up. Drusen area and PED height decreased significantly in the laser group, while no significant change appeared in the control group (74.1% vs. - 3.5%, P < 0.001; 76.6% vs. 0.1%, P < 0.001). Mean BCVA improved 4.6 letters in the laser group (vs. 1.1 letters in the control group, P = 0.019). As for safety, one study eye developed retinal pigment epithelial tear, and one control eye developed retinal angiomatous proliferation. Low energy laser photocoagulation and anti-VEGF injection in eyes with dPED showed some improvement in visual acuity. dPED regressed without developing center involving GA in the study eye, but a longer term follow-up is necessary to reveal the efficacy and safety of these treatments. The 2-year results of this study will be followed to reveal long term efficacy and safety of the treatment for dPED.

• Authors: Min Seok Kim, Na-Kyung Ryoo, Kyu Hyung Park
• Journal: Scientific reports (Sci Rep) Vol. 10 Issue 1 Pg. 14370 (09 01 2020) ISSN: 2045-2322 [Electronic] England
• PMID: 32873842 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Vascular Endothelial Growth Factor A
• Bevacizumab

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (administration & dosage)
• Bevacizumab (administration & dosage)
• Choroidal Neovascularization (prevention & control)
• Female
• Follow-Up Studies
• Geographic Atrophy (complications)
• Humans
• Low-Level Light Therapy (adverse effects)
• Macular Degeneration (drug therapy, radiotherapy)
• Male
• Middle Aged
• Pilot Projects
• Prospective Studies
• Retinal Detachment (drug therapy, radiotherapy)
• Retinal Perforations (etiology)
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity