Sub-threshold nanosecond laser (SNL) treatment in intermediate AMD (IAMD)

Area of Science:

• Ophthalmology
• Medical Imaging
• Laser Therapy

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Intermediate AMD (iAMD) is characterized by soft drusen.
• Early intervention aims to prevent progression to late AMD.

Purpose of the Study:

• To evaluate the efficacy of sub-threshold nanosecond laser (SNL) in slowing the progression of intermediate AMD.
• To assess the impact of SNL on the development of geographic atrophy (GA) or choroidal neovascularization (CNV).

Main Methods:

• A 36-month, multicenter, randomized, sham-controlled trial involving 292 participants with bilateral soft drusen.
• Participants received either SNL or sham treatment every 6 months.
• Multimodal imaging (MMI), including SD-OCT, AF, and NIR-R, was used to define outcomes.

Main Results:

• SNL did not significantly slow the progression to late AMD in the overall study group.
• Posthoc analysis revealed a significant benefit in patients without reticular pseudodrusen (RPD).
• Patients with RPD experienced a worse outcome with SNL treatment.

Conclusions:

• SNL may be beneficial for iAMD patients without coexistent RPD/subretinal drusenoid deposits (SDD).
• SNL may be inappropriate for patients with RPD/SDD.
• Further research is warranted to clarify the role of SNL in AMD management.