Long-term outcomes of drusenoid pigment epithelium detachment in intermediate AMD treated with 577 nm subthreshold micropulse laser: a preliminary clinical study

Zhen Huang; Kai-Yu Deng; Yu-Meng Deng; Yan-Nian Hui; Yan-Ping Song

doi:10.18240/ijo.2022.03.16

Long-term outcomes of drusenoid pigment epithelium detachment in intermediate AMD treated with 577 nm subthreshold micropulse laser: a preliminary clinical study

Int J Ophthalmol. 2022 Mar 18;15(3):474-482. doi: 10.18240/ijo.2022.03.16. eCollection 2022.

Authors

Zhen Huang^{1

2}, Kai-Yu Deng², Yu-Meng Deng², Yan-Nian Hui³, Yan-Ping Song^{1

2}

Affiliations

¹ The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
² Department of Ophthalmology, General Hospital of Central Theater Command, Wuhan 430070, Hubei Province, China.
³ Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.

Abstract

Aim: To evaluate the long-term anatomical and visual outcomes of drusenoid pigment epithelial detachment (D-PED) in intermediate age-related macular degeneration (AMD) eyes treated with 577 nm yellow subthreshold micropulse laser (SML).

Methods: In this retrospective study, 21 eyes of 16 patients with D-PED in intermediate AMD were consecutively included and assessed. All the eyes were treated with 577 nm SML in several sessions according to D-PED growth status. The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) were assessed at the initial visit and after treatment. Spectral-domain optical coherence tomography (SD-OCT) was performed to evaluate the D-PED lifecycle by volumetric calculations. Regression analysis was used to determine the breakpoint, growth, and collapse rate of the D-PED lesions. The progression to advanced AMD was also documented.

Results: All the eyes were treated with SML for 2.9±1.0 sessions. The mean follow-up period was 25.3±12.6mo. The BCVA was stable from the baseline to final visit. All the eyes were categorized into two groups according to the anatomical changes of the D-PED lesion: the collapse group (n=6, 28.6%) and non-collapse group (n=15, 71.4%). The change in logMAR BCVA did not differ significantly between the collapse group 0.00 (-0.31, 0.85) and non-collapse group 0.00 (0.00, 0.00; P=1). Regression analysis showed that the growth rate was significantly higher in the collapse group (0.090±0.095 mm³/mo) than in the non-collapse group (0.025±0.035 mm³/mo; P<0.001). One eye (4.8%) developed macular neovascularization at 11mo after SML treatment in the non-collapse group. Three eyes (14.3%) developed geographic atrophy (GA) in the collapse group.

Conclusion: Compared to the natural course of D-PED reported by previous studies, our results preliminarily show that SML can alleviate visual loss and possibility of progression to advanced AMD in eyes with D-PED in intermediate AMD. A controlled clinical trial needs to further verify the benefit of the intervention.

Keywords: age-related macular degeneration; drusenoid pigment detachment; optical coherence tomography; retinal pigment epithelium; subthreshold micropulse laser.

International Journal of Ophthalmology Press.